Universal Health Services (UHS) 10-Q 9 May 18 2018 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2018	Apr. 30, 2018
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q1
Trading Symbol	UHS
Entity Registrant Name	UNIVERSAL HEALTH SERVICES INC
Entity Central Index Key	352,915
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Class A
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		6,577,100
Class B
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		87,149,150
Class C
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		661,688
Class D
Document Information [Line Items]
Entity Common Stock, Shares Outstanding		18,673

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Income Statement [Abstract]
Net revenues before provision for doubtful accounts		$ 2,825,472
Less: Provision for doubtful accounts		212,614
Net revenues	$ 2,687,516	2,612,858
Operating charges:
Salaries, wages and benefits	1,300,148	1,237,964
Other operating expenses	620,819	607,360
Supplies expense	292,929	277,614
Depreciation and amortization	113,103	110,798
Lease and rental expense	26,703	25,189
Operating Expenses, Total	2,353,702	2,258,925
Income from operations	333,814	353,933
Interest expense, net	37,576	35,507
Income before income taxes	296,238	318,426
Provision for income taxes	67,569	107,899
Net income	228,669	210,527
Less: Net income attributable to noncontrolling interests	4,837	4,472
Net income attributable to UHS	$ 223,832	$ 206,055
Basic earnings per share attributable to UHS	$ 2.37	$ 2.13
Diluted earnings per share attributable to UHS	$ 2.36	$ 2.12
Weighted average number of common shares - basic	94,226	96,585
Add: Other share equivalents	457	787
Weighted average number of common shares and equivalents - diluted	94,683	97,372

Condensed Consolidated Stateme3

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 228,669	$ 210,527
Other comprehensive income (loss):
Unrealized derivative gains on cash flow hedges	2,124	3,066
Foreign currency translation adjustment	(4,341)	7,236
Other	2,367	1,094
Other comprehensive income before tax	150	11,396
Income tax expense related to items of other comprehensive income	1,077	1,551
Total other comprehensive income (loss), net of tax	(927)	9,845
Comprehensive income	227,742	220,372
Less: Comprehensive income attributable to noncontrolling interests	4,837	4,472
Comprehensive income attributable to UHS	$ 222,905	$ 215,900

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 73,053	$ 74,423
Accounts receivable, net	1,569,803	1,500,898
Supplies	137,246	136,177
Other current assets	104,624	86,504
Total current assets	1,884,726	1,798,002
Property and equipment	8,144,555	7,921,126
Less: accumulated depreciation	(3,444,003)	(3,349,289)
Property, plant and equipment, net, Total	4,700,552	4,571,837
Other assets:
Goodwill	3,843,126	3,825,157
Deferred charges	8,882	9,787
Deferred income taxes	3,072	3,007
Other	583,159	554,038
Total Assets	11,023,517	10,761,828
Current liabilities:
Current maturities of long-term debt	126,248	545,619
Accounts payable and accrued liabilities	1,366,333	1,284,081
Federal and state taxes	86,996	18,334
Total current liabilities	1,579,577	1,848,034
Other noncurrent liabilities	311,900	306,304
Long-term debt	3,795,087	3,494,390
Deferred income taxes	44,850	54,962
Redeemable noncontrolling interests	6,081	6,702
Equity:
UHS common stockholders’ equity	5,215,646	4,989,514
Noncontrolling interest	70,376	61,922
Total equity	5,286,022	5,051,436
Total Liabilities and Stockholders’ Equity	$ 11,023,517	$ 10,761,828

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Cash Flows from Operating Activities:
Net income	$ 228,669	$ 210,527
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization	113,134	110,798
Stock-based compensation expense	19,700	15,348
Gain on sale of assets and businesses	(703)	0
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable	(72,526)	(5,362)
Accrued interest	(6,209)	(6,123)
Accrued and deferred income taxes	61,674	102,269
Other working capital accounts	59,032	66,877
Other assets and deferred charges	(5,438)	(7,654)
Other	(37,642)	(229)
Accrued insurance expense, net of commercial premiums paid	23,125	22,007
Payments made in settlement of self-insurance claims	(18,765)	(25,349)
Net cash provided by operating activities	364,051	483,109
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(189,041)	(144,338)
Acquisition of property and businesses	(20,931)	(17,832)
Proceeds received from sales of assets and businesses	839	0
Costs incurred for purchase and implementation of information technology application	(8,570)	(9,456)
Decrease (increase) in capital reserves of commercial insurance subsidiary	100	(3,000)
Investment in, and advances to, joint venture	(8,675)	0
Net cash used in investing activities	(226,278)	(174,626)
Cash Flows from Financing Activities:
Reduction of long-term debt	(140,676)	(260,633)
Additional borrowings	20,500	21,600
Repurchase of common shares	(9,441)	(29,167)
Dividends paid	(9,422)	(9,662)
Issuance of common stock	2,545	2,540
Profit distributions to noncontrolling interests	(4,217)	(4,118)
Net cash used in financing activities	(140,711)	(279,440)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	1,857	285
(Decrease) increase in cash, cash equivalents and restricted cash	(1,081)	29,328
Cash, cash equivalents and restricted cash, beginning of period	167,297	121,950
Cash, cash equivalents and restricted cash, end of period	166,216	151,278
Supplemental Disclosures of Cash Flow Information:
Interest paid	41,539	39,404
Income taxes paid, net of refunds	2,749	5,253
Noncash purchases of property and equipment	$ 84,708	$ 56,427

General

General	3 Months Ended
	Mar. 31, 2018
Organization Consolidation And Presentation Of Financial Statements [Abstract]
General	(1) General This Quarterly Report on Form 10-Q is for the quarterly period ended March 31, 2018. In this Quarterly Report, “we,” “us,” “our” “UHS” and the “Company” refer to Universal Health Services, Inc. and its subsidiaries. The condensed consolidated interim financial statements include the accounts of our majority-owned subsidiaries and partnerships and limited liability companies controlled by us, or our subsidiaries, as managing general partner or managing member. The condensed consolidated interim financial statements included herein have been prepared by us, without audit, pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) and reflect all adjustments (consisting only of normal recurring adjustments) which, in our opinion, are necessary to fairly state results for the interim periods. Certain information and footnote disclosures normally included in audited consolidated financial statements prepared in accordance with accounting principles generally accepted in the United States of America have been condensed or omitted pursuant to such rules and regulations, although we believe that the accompanying disclosures are adequate to make the information presented not misleading. These condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements, significant accounting policies and the notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2017.

Relationship with Universal Hea

Relationship with Universal Health Realty Income Trust and Related Party Transactions	3 Months Ended
	Mar. 31, 2018
Related Party Transactions [Abstract]
Relationship with Universal Health Realty Income Trust and Related Party Transactions	(2) Relationship with Universal Health Realty Income Trust and Related Party Transactions Relationship with Universal Health Realty Income Trust: At March 31, 2018, we held approximately 5.7% of the outstanding shares of Universal Health Realty Income Trust (the “Trust”). We serve as Advisor to the Trust under an annually renewable advisory agreement, pursuant to the terms of which we conduct the Trust’s day-to-day affairs, provide administrative services and present investment opportunities. In addition, certain of our officers and directors are also officers and/or directors of the Trust. Management believes that it has the ability to exercise significant influence over the Trust, therefore we account for our investment in the Trust using the equity method of accounting. We earned an advisory fee from the Trust, which is included in net revenues in the accompanying consolidated statements of income, of approximately $900,000 Our pre-tax share of income from the Trust was approximately $284,000 and $1.8 million during the three-month periods ended March 31, 2018 and 2017, respectively. Included in our share of the Trust’s income for the three months ended March 31, 2017, is our share of a gain realized by the Trust in connection with the divestiture of property that was completed during the first quarter of 2017. The carrying value of this investment was approximately $8.5 million and $8.2 million at March 31, 2018 and December 31, 2017, respectively, and is included in other assets in the accompanying consolidated balance sheets. The market value of our investment in the Trust was $47.3 million at March 31, 2018 and $59.2 million at December 31, 2017, based on the closing price of the Trust’s stock on the respective dates. The Trust commenced operations in 1986 by purchasing certain properties from us and immediately leasing the properties back to our respective subsidiaries. Most of the leases were entered into at the time the Trust commenced operations and provided for initial terms of 13 to 15 years with up to six additional 5-year renewal terms. Each lease also provided for additional or bonus rental, as discussed below. The base rents are paid monthly and the bonus rents are computed and paid on a quarterly basis, based upon a computation that compares current quarter revenue to a corresponding quarter in the base year. The leases with those subsidiaries are unconditionally guaranteed by us and are cross-defaulted with one another. Total rent expense under the operating leases on the three hospital facilities reflected in the table below was approximately $4 million during each of the three months ended March 31, 2018 and 2017. Pursuant to the terms of the three hospital leases with the Trust, we have the option to renew the leases at the lease terms described above by providing notice to the Trust at least 90 days prior to the termination of the then current term. We also have the right to purchase the respective leased hospitals at the end of the lease terms or any renewal terms at their appraised fair market value as well as purchase any or all of the three leased hospital properties at the appraised fair market value upon one month’s notice should a change of control of the Trust occur. In addition, we have rights of first refusal to: (i) purchase the respective leased facilities during and for 180 days after the lease terms at the same price, terms and conditions of any third-party offer, or; (ii) renew the lease on the respective leased facility at the end of, and for 180 days after, the lease term at the same terms and conditions pursuant to any third-party offer. The table below details the renewal options and terms for each of our three acute care hospital facilities leased from the Trust: Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2021 10(a) Wellington Regional Medical Center $ 3,030,000 December, 2021 10(b) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2021 10(b) (a) We have two 5-year renewal options at existing lease rates (through 2031). (b) We have two 5-year renewal options at fair market value lease rates (2022 through 2031). In addition, certain of our subsidiaries are tenants in several medical office buildings and two FEDs owned by the Trust or by limited liability companies in which the Trust holds 95% to 100% of the ownership interest. Other Related Party Transactions: In December, 2010, our Board of Directors approved the Company’s entering into supplemental life insurance plans and agreements on the lives of Alan B. Miller (our chief executive officer) and his wife. As a result of these agreements, as amended in October, 2016, based on actuarial tables and other assumptions, during the life expectancies of the insureds, we would pay approximately $28 million in premiums, and certain trusts owned by our chief executive officer (“CEO”), would pay approximately $9 million in premiums. Based on the projected premiums mentioned above, and assuming the policies remain in effect until the death of the insureds, we will be entitled to receive death benefit proceeds of no less than approximately $37 million representing the $28 million of aggregate premiums paid by us as well as the $9 million of aggregate premiums paid by the trusts. In connection with these policies, we will pay/we paid approximately $1.1 million and $1.2 million in premium payments during each of 2018 and 2017, respectively. In August, 2015, Marc D. Miller, our President and member of our Board of Directors, was appointed to the Board of Directors of Premier, Inc. (“Premier”), a healthcare performance improvement alliance. During 2013, we entered into a new group purchasing organization agreement (“GPO”) with Premier. In conjunction with the GPO agreement, we acquired a minority interest in Premier for a nominal amount. During the fourth quarter of 2013, in connection with the completion of an initial public offering of the stock of Premier, we received cash proceeds for the sale of a portion of our ownership interest in the GPO. Also in connection with this GPO agreement, we received shares of restricted stock of Premier which vest ratably over a seven-year period (2014 through 2020), contingent upon our continued participation and minority ownership interest in the GPO. We have elected to retain a portion of the previously vested shares of Premier, the market value of which is included in other assets on our consolidated balance sheet. Based upon the closing price of Premier’s stock on each respective date, the market value of our shares of Premier on which the restrictions have lapsed was $35 million as of March 31, 2018 and $33 million as of December 31, 2017. A member of our Board of Directors and member of the Executive Committee and Finance Committee is a Partner in Norton Rose Fulbright US LLP, a law firm engaged by us for a variety of legal services. This Board member also provides personal legal services to our CEO and acts as trustee of certain trusts for the benefit of our CEO and his family.

Other Noncurrent liabilities an

Other Noncurrent liabilities and Redeemable/Noncontrolling Interests	3 Months Ended
	Mar. 31, 2018
Noncontrolling Interest [Abstract]
Other Noncurrent liabilities and Redeemable/Noncontrolling Interests	(3) Other Noncurrent liabilities and Redeemable/Noncontrolling Interests Other noncurrent liabilities include the long-term portion of our professional and general liability, workers’ compensation reserves, pension and deferred compensation liabilities, and liabilities incurred in connection with split-dollar life insurance agreements on the lives of our chief executive officer and his wife. As of March 31, 2018, outside owners held noncontrolling, minority ownership interests of: (i) 20% in an acute care facility located in Washington, D.C.; (ii) approximately 11% in an acute care facility located in Texas; (iii) 20% and 30% in two behavioral health care facilities located in Pennsylvania and Ohio, respectively; (iv) approximately 5% in an acute care facility located in Nevada, and; (v) approximately 20% in an under-construction behavioral health care facility located in Spokane, Washington with an expected October 2018 opening. The noncontrolling interest and redeemable noncontrolling interest balances of $70 million and $6 million, respectively, as of March 31, 2018, consist primarily of the third-party ownership interests in these hospitals. In connection with the two behavioral health care facilities located in Pennsylvania and Ohio, the minority ownership interests of which are reflected as redeemable noncontrolling interests on our Condensed Consolidated Balance Sheet, the outside owners have “put options” to put their entire ownership interest to us at any time. If exercised, the put option requires us to purchase the minority member’s interest at fair market value.

Treasury

Treasury	3 Months Ended
	Mar. 31, 2018
Equity [Abstract]
Treasury	(4) Treasury Debt: On June 7, 2016, we entered into a Fifth Amendment (the “Fifth Amendment”) to our credit agreement dated as of November 15, 2010, as amended on March 15, 2011, September 21, 2012, May 16, 2013 and August 7, 2014, among UHS, as borrower, the several banks and other financial institutions from time to time parties thereto, as lenders (“Credit Agreement”). The Fifth Amendment increased the size of the term loan A facility by $200 million and those proceeds were utilized to repay outstanding borrowings under the revolving credit facility of the Credit Agreement. The Credit Agreement, as amended, which is scheduled to mature in August, 2019, consists of: (i) an $800 million revolving credit facility ($285 million of borrowings outstanding as of March 31, 2018), and; (ii) a term loan A facility with $1.753 billion of borrowings outstanding as of March 31, 2018. Borrowings under the Credit Agreement bear interest at our election at either (1) the ABR rate which is defined as the rate per annum equal to the greatest of (a) the lender’s prime rate, (b) the weighted average of the federal funds rate, plus 0.5% and (c) one month LIBOR rate plus 1%, in each case, plus an applicable margin based upon our consolidated leverage ratio at the end of each quarter ranging from 0.50% to 1.25% for revolving credit and term loan-A borrowings, or (2) the one, two, three or six month LIBOR rate (at our election), plus an applicable margin based upon our consolidated leverage ratio at the end of each quarter ranging from 1.50% to 2.25% for revolving credit and term loan-A borrowings. As of March 31, 2018, the applicable margins were 0.50% for ABR-based loans and 1.50% for LIBOR-based loans under the revolving credit and term loan-A facilities. As of March 31, 2018, we had $285 million of borrowings outstanding pursuant to the terms of our $800 million revolving credit facility and we had $446 million of available borrowing capacity net of $34 million of outstanding letters of credit and $35 million of outstanding borrowings pursuant to a short-term, on demand-credit facility. The revolving credit facility includes a $125 million sub-limit for letters of credit. The Credit Agreement is secured by certain assets of the Company (which generally excludes asset classes such as substantially all of the patient-related accounts receivable of our acute care hospitals, certain real estate assets and assets held in joint-ventures with third-parties) and our material subsidiaries and guaranteed by our material subsidiaries. Pursuant to the terms of the Credit Agreement, term loan-A quarterly installment payments of approximately $22 million commenced during the fourth quarter of 2016 and are scheduled through June, 2019. Previously, approximately $11 million of quarterly installment payments were made from the fourth quarter of 2014 through the third quarter of 2016. The Credit Agreement includes a material adverse change clause that must be represented at each draw. The Credit Agreement contains covenants that include a limitation on sales of assets, mergers, change of ownership, liens and indebtedness, transactions with affiliates, dividends and stock repurchases; and requires compliance with financial covenants including maximum leverage and minimum interest coverage ratios. We are in compliance with all required covenants as of March 31, 2018. In late April, 2018, we entered into the sixth amendment to our accounts receivable securitization program (“Securitization”), dated as of October 27, 2010 with a group of conduit lenders, liquidity banks, and PNC Bank, National Association, as administrative agent, which provides for borrowings outstanding from time to time by certain of our subsidiaries in exchange for undivided security interests in their respective accounts receivable. The sixth amendment, among other things, extended the term of the Securitization program through April 26, 2021 and increased the borrowing capacity to $450 million (from $440 million previously). Although the program fee and certain other fees were adjusted in connection with the sixth amendment, substantially all other provisions of the Securitization program remained unchanged. Pursuant to the terms of our Securitization program, substantially all of the patient-related accounts receivable of our acute care hospitals (“Receivables”) serve as collateral for the outstanding borrowings. We have accounted for this Securitization as borrowings. We maintain effective control over the Receivables since, pursuant to the terms of the Securitization, the Receivables are sold from certain of our subsidiaries to special purpose entities that are wholly-owned by us. The Receivables, however, are owned by the special purpose entities, can be used only to satisfy the debts of the wholly-owned special purpose entities, and thus are not available to us except through our ownership interest in the special purpose entities. The wholly-owned special purpose entities use the Receivables to collateralize the loans obtained from the group of third-party conduit lenders and liquidity banks. The group of third-party conduit lenders and liquidity banks do not have recourse to us beyond the assets of the wholly-owned special purpose entities that securitize the loans. At March 31, 2018, we had $440 million of outstanding borrowings pursuant to the terms of the Securitization and no available borrowing capacity, before giving effect to the $10 million increase in borrowing capacity effective in April, 2018 pursuant to the terms of the sixth amendment. As of March 31, 2018, we had combined aggregate principal of $1.4 billion from the following senior secured notes: • $300 million aggregate principal amount of 3.75% senior secured notes due in August, 2019 (“2019 Notes”) which were issued on August 7, 2014. • $700 million aggregate principal amount of 4.75% senior secured notes due in August, 2022 (“2022 Notes”) which were issued as follows: o $300 million aggregate principal amount issued on August 7, 2014 at par. o $400 million aggregate principal amount issued on June 3, 2016 at 101.5% to yield 4.35%. • $400 million aggregate principal amount of 5.00% senior secured notes due in June, 2026 (“2026 Notes”) which were issued on June 3, 2016. Interest is payable on the 2019 Notes and the 2022 Notes on February 1 and August 1 of each year until the maturity date of August 1, 2019 for the 2019 Notes and August 1, 2022 for the 2022 Notes. Interest on the 2026 Notes is payable on June 1 and December 1 until the maturity date of June 1, 2026. The 2019 Notes, 2022 Notes and 2026 Notes were offered only to qualified institutional buyers under Rule 144A and to non-U.S. persons outside the United States in reliance on Regulation S under the Securities Act of 1933, as amended (the “Securities Act”). The 2019 Notes, 2022 Notes and 2026 Notes have not been registered under the Securities Act and may not be offered or sold in the United States absent registration or an applicable exemption from registration requirements. At March 31, 2018, the carrying value and fair value of our debt were each approximately $3.9 billion. At December 31, 2017, the carrying value and fair value of our debt were approximately $4.0 billion and $4.1 billion, respectively. The fair value of our debt was computed based upon quotes received from financial institutions. We consider these to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with debt instruments. Cash Flow Hedges: We manage our ratio of fixed and floating rate debt with the objective of achieving a mix that management believes is appropriate. To manage this risk in a cost-effective manner, we, from time to time, enter into interest rate swap agreements in which we agree to exchange various combinations of fixed and/or variable interest rates based on agreed upon notional amounts. We account for our derivative and hedging activities using the Financial Accounting Standard Board’s (“FASB”) guidance which requires all derivative instruments, including certain derivative instruments embedded in other contracts, to be carried at fair value on the balance sheet. For derivative transactions designated as hedges, we formally document all relationships between the hedging instrument and the related hedged item, as well as its risk-management objective and strategy for undertaking each hedge transaction. Derivative instruments designated in a hedge relationship to mitigate exposure to variability in expected future cash flows, or other types of forecasted transactions, are considered cash flow hedges. Cash flow hedges are accounted for by recording the fair value of the derivative instrument on the balance sheet as either an asset or liability, with a corresponding amount recorded in accumulated other comprehensive income (“AOCI”) within shareholders’ equity. Amounts are reclassified from AOCI to the income statement in the period or periods the hedged transaction affects earnings. We use interest rate derivatives in our cash flow hedge transactions. Such derivatives are designed to be highly effective in offsetting changes in the cash flows related to the hedged liability. For derivative instruments designated as cash flow hedges, the ineffective portion of the change in expected cash flows of the hedged item are recognized currently in the income statement. For hedge transactions that do not qualify for the short-cut method, at the hedge’s inception and on a regular basis thereafter, a formal assessment is performed to determine whether changes in the fair values or cash flows of the derivative instruments have been highly effective in offsetting changes in cash flows of the hedged items and whether they are expected to be highly effective in the future. The fair value of interest rate swap agreements approximates the amount at which they could be settled, based on estimates obtained from the counterparties. We assess the effectiveness of our hedge instruments on a quarterly basis. We performed periodic assessments of the cash flow hedge instruments during the first three months of 2018 and the full year of 2017 and determined the hedges to be highly effective. We also determined that any portion of the hedges deemed to be ineffective was de minimis and therefore there was no material effect on our consolidated financial position, operations or cash flows. The counterparties to the interest rate swap agreements expose us to credit risk in the event of nonperformance. We do not anticipate nonperformance by our counterparties. We do not hold or issue derivative financial instruments for trading purposes. Seven interest rate swaps on a total notional amount of $825 million matured in May, 2015. During 2015, we entered into nine forward starting interest rate swaps whereby we pay a fixed rate on a total notional amount of $1.0 billion and receive one-month LIBOR. The average fixed rate payable on these swaps, which are scheduled to mature on April 15, 2019, is 1.31%. These interest rates swaps consist of: • Four forward starting interest rate swaps, entered into during the second quarter of 2015, whereby we pay a fixed rate on a total notional amount of $500 million and receive one-month LIBOR. Each of the four swaps became effective on July 15, 2015 and are scheduled to mature on April 15, 2019. The average fixed rate payable on these swaps is 1.40%; • Four forward starting interest rate swaps, entered into during the third quarter of 2015, whereby we pay a fixed rate on a total notional amount of $400 million and receive one-month LIBOR. One swap on a notional amount of $100 million became effective on July 15, 2015, two swaps on a total notional amount of $200 million became effective on September 15, 2015 and another swap on a notional amount of $100 million became effective on December 15, 2015. All of these swaps are scheduled to mature on April 15, 2019. The average fixed rate payable on these four swaps is 1.23%, and; • One interest rate swap, entered into during the fourth quarter of 2015, whereby we pay a fixed rate on a total notional amount of $100 million and receive one-month LIBOR. The swap became effective on December 15, 2015 and is scheduled to mature on April 15, 2019. The fixed rate payable on this swap is 1.21%. We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based on quotes from our counterparties. We consider those inputs to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with derivative instruments and hedging activities. At March 31, 2018, the fair value of our interest rate swaps was a net asset of $9 million, $8 million of which is included in net accounts receivable and $1 million of which is included in other assets on the accompanying balance sheet. At December 31, 2017, the fair value of our interest rate swaps was a net asset of $7 million, $4 million of which is included in net accounts receivable and $3 million of which is included in other assets on the accompanying consolidated balance sheet. Foreign Currency Forward Exchange Contracts: We use forward exchange contracts to hedge our net investment in foreign operations against movements in exchange rates. The effective portion of the unrealized gains or losses on these contracts is recorded in foreign currency translation adjustment within accumulated other comprehensive income and remains there until either the sale or liquidation of the subsidiary. The cash flows from these contracts are reported as operating activities in the consolidated statements of cash flows. In connection with these forward exchange contracts, we recorded net cash outflows of $46 million and $8 million during the three-month periods ended March 31, 2018 and 2017, respectively. Cash, Cash Equivalents and Restricted Cash: Cash, cash equivalents, and restricted cash as reported in the condensed consolidated statements of cash flows are presented separately on our condensed consolidated balance sheets as follow (in thousands): March 31, December 31, 2018 2017 Cash and cash equivalents $ 73,053 $ 74,423 Restricted cash (a) 93,163 92,874 Total cash, cash equivalents and restricted cash $ 166,216 $ 167,297 (a) Restricted cash, associated with an insurance subsidiary, is included in other assets on the accompanying consolidated balance sheet. The fair value of our restricted cash was computed based upon quotes received from financial institutions. We consider these to be “level 1” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with financial securities.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2018
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	(5) Commitments and Contingencies Professional and General Liability, Workers’ Compensation Liability Effective January, 2017, the vast majority of our subsidiaries are self-insured for professional and general liability exposure up to $5 million and $3 million per occurrence, respectively, subject to certain aggregate limitations. Prior to January, 2017, the vast majority of our subsidiaries were self-insured for professional and general liability exposure up to $10 million and $3 million per occurrence, respectively. These subsidiaries are provided with several excess policies through commercial insurance carriers which provide for coverage in excess of the applicable per occurrence self-insured retention or underlying policy limits incurred after 2013 a As of March 31, 2018, the total accrual for our professional and general liability claims was $232 million, of which $54 million was included in current liabilities. As of December 31, 2017, the total accrual for our professional and general liability claims was $229 million, of which $54 million was included in current liabilities. At each of March 31, 2018 and December 31, 2017, the total accrual for our workers’ compensation liability claims was $70 million, of which $35 million is included in current liabilities. Our estimated liability for self-insured professional and general liability claims is based on a number of factors including, among other things, the number of asserted claims and reported incidents, estimates of losses for these claims based on recent and historical settlement amounts, estimates of incurred but not reported claims based on historical experience, and estimates of amounts recoverable under our commercial insurance policies. While we continuously monitor these factors, our ultimate liability for professional and general liability claims could change materially from our current estimates due to inherent uncertainties involved in making this estimate. Given our significant self-insured exposure for professional and general liability claims, there can be no assurance that a sharp increase in the number and/or severity of claims asserted against us will not have a material adverse effect on our future results of operations. Although we are unable to predict whether or not our future financial statements will include adjustments to our prior year reserves for self-insured general and professional and workers’ compensation claims, given the relatively unpredictable nature of the these potential liabilities and the factors impacting these reserves, as discussed above, it is reasonably likely that our future financial results may include material adjustments to prior period reserves. Property Insurance: We have commercial property insurance policies for our properties covering catastrophic losses, including windstorm damage, up to a $1 billion policy limit, subject to a deductible ranging from $50,000 to $250,000 per occurrence. Losses resulting from named windstorms are subject to deductibles between 3% and 5% of the total insurable value of the property. In addition, we have commercial property insurance policies covering catastrophic losses resulting from earthquake and flood damage, each subject to aggregated loss limits (as opposed to per occurrence losses). Commercially insured earthquake coverage for our facilities is subject to various deductibles and limitations including: (i) $500 million limitation for our facilities located in Nevada; (ii) $130 million limitation for our facilities located in California; (iii) $100 million limitation for our facilities located in fault zones within the United States; (iv) $40 million limitation for our facility located in Puerto Rico, and; (v) $250 million limitation for many of our facilities located in other states. Deductibles for flood losses vary in amount, up to a maximum of $500,000, based upon location of the facility. Since certain of our facilities have been designated by our insurer as flood prone, we have elected to purchase policies from The National Flood Insurance Program. Property insurance for our behavioral health facilities located in the U.K. are provided on an all risk basis up to a £1.29 billion policy limit, with coverage caps per location, that includes coverage for real and personal property as well as business interruption losses. Other Our accounts receivable as of March 31, 2018 and December 31, 2017 include amounts due from Illinois of approximately $35 million and $25 million, respectively. Collection of the outstanding receivables continues to be delayed due to state budgetary and funding pressures. Approximately $15 million as of March 31, 2018 and $8 million as of December 31, 2017, of the receivables due from Illinois were outstanding in excess of 60 days, as of each respective date. Although the accounts receivable due from Illinois could remain outstanding for the foreseeable future, since we expect to eventually collect all amounts due to us, no related reserves have been established in our consolidated financial statements. However, we can provide no assurance that we will eventually collect all amounts due to us from Illinois. Failure to ultimately collect all outstanding amounts due to us from Illinois would have an adverse impact on our future consolidated results of operations and cash flows. As of March 31, 2018 we were party to certain off balance sheet arrangements consisting of standby letters of credit and surety bonds which totaled $117 million consisting of: (i) $108 million related to our self-insurance programs, and; (ii) $9 million of other debt and public utility guarantees. Legal Proceedings We operate in a highly regulated and litigious industry which subjects us to various claims and lawsuits in the ordinary course of business as well as regulatory proceedings and government investigations. These claims or suits include claims for damages for personal injuries, medical malpractice, commercial/contractual disputes, wrongful restriction of, or interference with, physicians’ staff privileges, and employment related claims. In addition, health care companies are subject to investigations and/or actions by various state and federal governmental agencies or those bringing claims on their behalf. Government action has increased with respect to investigations and/or allegations against healthcare providers concerning possible violations of fraud and abuse and false claims statutes as well as compliance with clinical and operational regulations. Currently, and from time to time, we and some of our facilities are subjected to inquiries in the form of subpoenas, Civil Investigative Demands, audits and other document requests from various federal and state agencies. These inquiries can lead to notices and/or actions including repayment obligations from state and federal government agencies associated with potential non-compliance with laws and regulations. Further, the federal False Claim Act allows private individuals to bring lawsuits (qui tam actions) against healthcare providers that submit claims for payments to the government. Various states have also adopted similar statutes. When such a claim is filed, the government will investigate the matter and decide if they are going to intervene in the pending case. These qui tam lawsuits are placed under seal by the court to comply with the False Claims Act’s requirements. If the government chooses not to intervene, the private individual(s) can proceed independently on behalf of the government. Health care providers that are found to violate the False Claims Act may be subject to substantial monetary fines/penalties as well as face potential exclusion from participating in government health care programs or be required to comply with Corporate Integrity Agreements as a condition of a settlement of a False Claim Act matter. In September 2014, the Criminal Division of the Department of Justice (“DOJ”) announced that all qui tam cases will be shared with their Division to determine if a parallel criminal investigation should be opened. The DOJ has also announced an intention to pursue civil and criminal actions against individuals within a company as well as the corporate entity or entities. In addition, health care facilities are subject to monitoring by state and federal surveyors to ensure compliance with program Conditions of Participation. In the event a facility is found to be out of compliance with a Condition of Participation and unable to remedy the alleged deficiency(s), the facility faces termination from the Medicare and Medicaid programs or compliance with a System Improvement Agreement to remedy deficiencies and ensure compliance. The laws and regulations governing the healthcare industry are complex covering, among other things, government healthcare participation requirements, licensure, certification and accreditation, privacy of patient information, reimbursement for patient services as well as fraud and abuse compliance. These laws and regulations are constantly evolving and expanding. Further, the Affordable Care Act has added additional obligations on healthcare providers to report and refund overpayments by government healthcare programs and authorizes the suspension of Medicare and Medicaid payments “pending an investigation of a credible allegation of fraud.” We monitor our business and have developed an ethics and compliance program with respect to these complex laws, rules and regulations. Although we believe our policies, procedures and practices comply with government regulations, there is no assurance that we will not be faced with the sanctions referenced above which include fines, penalties and/or substantial damages, repayment obligations, payment suspensions, licensure revocation, and expulsion from government healthcare programs. Even if we were to ultimately prevail in any action brought against us or our facilities or in responding to any inquiry, such action or inquiry could have a material adverse effect on us. Certain legal matters are described below: Government Investigations: UHS Behavioral Health In February, 2013, the Office of Inspector General for the United States Department of Health and Human Services (“OIG”) served a subpoena requesting various documents from January, 2008 to the date of the subpoena directed at Universal Health Services, Inc. (“UHS”) concerning it and UHS of Delaware, Inc., and certain UHS owned behavioral health facilities including: Keys of Carolina, Old Vineyard Behavioral Health, The Meadows Psychiatric Center, Streamwood Behavioral Health, Hartgrove Hospital, Rock River Academy and Residential Treatment Center, Roxbury Treatment Center, Harbor Point Behavioral Health Center, f/k/a The Pines Residential Treatment Center, including the Crawford, Brighton and Kempsville campuses, Wekiva Springs Center and River Point Behavioral Health. Prior to receipt of this subpoena, some of these facilities had received independent subpoenas from state or federal agencies. Subsequent to the February 2013 subpoenas, some of the facilities above have received additional, specific subpoenas or other document and information requests. In addition to the OIG, the DOJ and various U.S. Attorneys’ and state Attorneys’ General Offices are also involved in this matter. Since February 2013, additional facilities have also received subpoenas and/or document and information requests or we have been notified are included in the omnibus investigation. Those facilities include: National Deaf Academy, Arbour-HRI Hospital, Behavioral Hospital of Bellaire, St. Simons By the Sea, Turning Point Care Center, Salt Lake Behavioral Health, Central Florida Behavioral Hospital, University Behavioral Center, Arbour Hospital, Arbour-Fuller Hospital, Pembroke Hospital, Westwood Lodge, Coastal Harbor Health System, Shadow Mountain Behavioral Health, Cedar Hills Hospital, Mayhill Hospital, Southern Crescent Behavioral Health (Anchor Hospital and Crescent Pines campuses), Valley Hospital (AZ), Peachford Behavioral Health System of Atlanta, University Behavioral Health of Denton, and El Paso Behavioral Health System. In October, 2013, we were advised that the DOJ’s Criminal Frauds Section had opened an investigation of River Point Behavioral Health and Wekiva Springs Center. Since that time, we have been notified that the Criminal Frauds section has opened investigations of National Deaf Academy, Hartgrove Hospital and UHS as a corporate entity. In April 2017, the DOJ’s Criminal Division issued a subpoena requesting documentation from Shadow Mountain Behavioral Health. In August 2017, Kempsville Center of Behavioral Health (a part of Harbor Point Behavioral Health previously identified above) received a subpoena requesting documentation. In April, 2014, the Centers for Medicare and Medicaid Services (“CMS”) instituted a Medicare payment suspension at River Point Behavioral Health in accordance with federal regulations regarding suspension of payments during certain investigations. The Florida Agency for Health Care Administration (“AHCA”) subsequently issued a Medicaid payment suspension for the facility. River Point Behavioral Health submitted a rebuttal statement disputing the basis of the suspension and requesting revocation of the suspension. Notwithstanding, CMS continued the payment suspension. River Point Behavioral Health provided additional information to CMS in an effort to obtain relief from the payment suspension but the Medicare suspension remains in effect. In June 2017, AHCA advised that while they were maintaining the suspension for dual eligible and cross-over Medicare beneficiaries, the Medicaid payment suspension was lifted effective June 27, 2017. We cannot predict if and/or when the facility’s remaining suspended payments will resume in total. From inception through March 31, 2018, the aggregate funds withheld from us in connection with the River Point Behavioral Health payment suspension amounted to approximately $10 million. Although the operating results of River Point Behavioral Health did not have a material impact on our consolidated results of operations during the three-month period ended March 31, 2018 or the year ended December 31, 2017, the payment suspension has had a material adverse effect on the facility’s results of operations and financial condition. The DOJ has advised us that the civil aspect of the coordinated investigation referenced above is a False Claims Act investigation focused on billings submitted to government payors in relation to services provided at those facilities. During the first quarter of 2018, we recorded a $13 million pre-tax increase to the reserve established in connection with the civil aspects of these matters increasing the aggregate pre-tax reserve to $35 million. Changes in the reserve may be required in future periods as discussions with the DOJ continue and additional information becomes available. We cannot predict the ultimate resolution of these matters and therefore can provide no assurance that final amounts paid in settlement or otherwise, if any, or associated costs, will not differ materially from our established reserve. Litigation: U.S. ex rel Escobar v. Universal Health Services, Inc. et.al. This is a False Claims Act case filed against Universal Health Services, Inc., UHS of Delaware, Inc. and HRI Clinics, Inc. d/b/a Arbour Counseling Services in U.S. District Court for the District of Massachusetts. This qui tam action primarily alleges that Arbour Counseling Services failed to appropriately supervise certain clinical providers in contravention of regulatory requirements and the submission of claims to Medicaid were subsequently improper. Relators make other claims of improper billing to Medicaid associated with alleged failures of Arbour Counseling to comply with state regulations. The U.S. Attorney’s Office and the Massachusetts Attorney General’s Office initially declined to intervene. UHS filed a motion to dismiss and the trial court originally granted the motion dismissing the case. The First Circuit Court of Appeals (“First Circuit”) reversed the trial court’s dismissal of the case. The United States Supreme Court subsequently vacated the First Circuit’s opinion and remanded the case for further consideration under the new legal standards established by the Supreme Court for False Claims Act cases. During the 4 th Shareholder Class Action In December 2016 a purported shareholder class action lawsuit was filed in U.S. District Court for the Central District of California against UHS, and certain UHS officers alleging violations of the federal securities laws. Plaintiff alleges that defendants violated federal securities laws relating to the disclosures made in public filings associated with practices at our behavioral health facilities. The case was originally filed as Heed v. Universal Health Services, Inc. et. al. (Case No. 2:16-CV-09499-PSG-JC). The court subsequently appointed Teamsters Local 456 Pension Fund and Teamsters Local 456 Annuity Fund to serve as lead plaintiffs. The case has been transferred to the U.S. District Court for the Eastern District of Pennsylvania and the style of the case has been changed to Teamsters Local 456 Pension Fund, et. al. v. Universal Health Services, Inc. et. al. (Case No. 2:17-CV-02817-LS). In September, 2017, Teamsters Local 456 Pension Fund filed an amended complaint. In December 2017, we filed a motion to dismiss the amended complaint. We deny liability and intend to defend ourselves vigorously. At this time, we are uncertain as to potential liability or financial exposure, if any, which may be associated with this matter. Shareholder Derivative Cases In March 2017, a shareholder derivative suit was filed by plaintiff David Heed in the Court of Common Pleas of Philadelphia County. A notice of removal to the United States District Court for the Eastern District of Pennsylvania was filed (Case No. 2:17-cv-01476-LS). Plaintiff filed a motion to remand. In December 2017, the Court denied plaintiff’s motion to remand and has retained the case in federal court. The suit alleges breaches of fiduciary duties and other allegedly wrongful conduct by the members of the Board of Directors and certain officers of Universal Health Services, Inc. relating to practices at our behavioral health facilities. UHS has been named as a nominal defendant in the case. In May, June and July 2017, additional shareholder derivative suits were filed in the United States District Court for the Eastern District of Pennsylvania. The plaintiffs in those cases are: Central Laborers’ Pension Fund (Case No. 17-cv-02187-LS); Firemen’s Retirement System of St. Louis (Case No. 17—cv-02317-LS); Waterford Township Police & Fire Retirement System (Case No. 17-cv-02595-LS); and Amalgamated Bank Longview Funds (Case No. 17-cv-03404-LS). The Fireman’s Retirement System case has since been voluntarily dismissed. The federal court has consolidated all of the cases pending in the Eastern District of Pennsylvania and has appointed Amalgamated Bank Longview Funds as the lead plaintiff and their counsel as lead counsel. In addition, a shareholder derivative case was filed in Chancery Court in Delaware by the Delaware County Employees’ Retirement Fund (Case No. 2017-0475-JTL). In December 2017, the Chancery Court stayed this case pending resolution of other contemporaneous matters. These additional cases make substantially similar allegations and claims based upon alleged violations of federal securities laws as well common law causes of action against the individual defendants. All of these additional cases have also named members of the UHS Board of Directors as well as certain officers of the Company. The defendants deny liability and intend to defend these cases vigorously. At this time, we are uncertain as to potential liability or financial exposure, if any, which may be associated with these matters. Chowdary v. Universal Health Services, Inc., et. al. This is a lawsuit filed in 1999 in state court in Hidalgo County, Texas by a physician and his professional associations alleging tortious interference with contractual relationships and retaliation against McAllen Medical Center in McAllen, Texas as well as Universal Health Services, Inc. The state court has entered a summary judgment order awarding plaintiff $3.85 million in damages. With prejudgment interest, the total amount of the order amounts to approximately $9 million, for which a reserve is included in our financial statements as of December 31, 2017. A trial on punitive damages, emotional distress and attorneys’ fees remains to be conducted if the summary judgment order is not vacated. The case has been removed to federal court. Plaintiffs filed a motion to remand. In February 2018, the federal court denied plaintiffs’ motion to remand and retained the case in federal court. Plaintiffs have filed a writ of mandamus with the 5 th Disproportionate Share Hospital Payment Matter: In late September, 2015, many hospitals in Pennsylvania, including seven of our behavioral health care hospitals located in the state, received letters from the Pennsylvania Department of Human Services (the “Department”) demanding repayment of allegedly excess Medicaid Disproportionate Share Hospital payments (“DSH”) for the federal fiscal year 2011 (“FFY2011”) amounting to approximately $4 million in the aggregate. Since that time, we have received similar requests for repayment for alleged DSH overpayments for FFYs 2012 and 2013 aggregating to approximately $11 million. We filed administrative appeals for all of our facilities contesting the recoupment efforts for FFYs 2011 through 2013 as we believe the Department’s calculation methodology is inaccurate and conflicts with applicable federal and state laws and regulations. The Department has agreed to postpone the recoupment of the state’s share of the DSH payments until all hospital appeals are resolved but started recoupment of the federal share. The Department will likely make similar repayment demand for FFY 2014. Due to a change in the Pennsylvania Medicaid State Plan and implementation of a CMS-approved Medicaid Section 1115 Waiver, we do not believe the methodology applied by the Department to FFYs 2011 through 2013 is applicable to reimbursements received for Medicaid services provided after January 1, 2015 by our behavioral health care facilities located in Pennsylvania. We can provide no assurance that we will ultimately be successful in our legal and administrative appeals related to the Department’s repayment demands. If our legal and administrative appeals are unsuccessful, our future consolidated results of operations and financial condition could be adversely impacted by these repayments. Matters Relating to Psychiatric Solutions, Inc. (“PSI”): The following matters pertain to PSI or former PSI facilities (owned by subsidiaries of PSI) which were in existence prior to the acquisition of PSI and for which we have assumed the defense as a result of our acquisition which was completed in November, 2010: Department of Justice Investigation of Riveredge Hospital In 2008, Riveredge Hospital in Chicago, Illinois received a subpoena from the DOJ requesting certain information from the facility. Additional requests for documents were also received from the DOJ in 2009 and 2010. The requested documents have been provided to the DOJ. All documents requested and produced pertained to the operations of the facility while under PSI’s ownership prior to our acquisition. At present, we are uncertain as to the focus, scope or extent of the investigation, liability of the facility and/or potential financial exposure, if any, in connection with this matter. Department of Justice Investigation of Friends Hospital In October, 2010, Friends Hospital in Philadelphia, Pennsylvania, received a subpoena from the DOJ requesting certain documents from the facility. The requested documents were collected and provided to the DOJ for review and examination. Another subpoena was issued to the facility in July, 2011 requesting additional documents, which have also been delivered to the DOJ. All documents requested and produced pertained to the operations of the facility while under PSI’s ownership prior to our acquisition. At present, we are uncertain as to the focus, scope or extent of the investigation, liability of the facility and/or potential financial exposure, if any, in connection with this matter. Other Matters: Various other suits, claims and investigations, including government subpoenas, arising against, or issued to, us are pending and additional such matters may arise in the future. Management will consider additional disclosure from time to time to the extent it believes such matters may be or become material. The outcome of any current or future litigation or governmental or internal investigations, including the matters described above, cannot be accurately predicted, nor can we predict any resulting penalties, fines or other sanctions that may be imposed at the discretion of federal or state regulatory authorities. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. No estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made at this time regarding the matters described above or that are otherwise pending because the inherently unpredictable nature of legal proceedings may be exacerbated by various factors, including, but not limited to: (i) the damages sought in the proceedings are unsubstantiated or indeterminate; (ii) discovery is not complete; (iii) the matter is in its early stages; (iv) the matters present legal uncertainties; (v) there are significant facts in dispute; (vi) there are a large number of parties, or; (vii) there is a wide range of potential outcomes. It is possible that the outcome of these matters could have a material adverse impact on our future results of operations, financial position, cash flows and, potentially, our reputation.

Segment Reporting

Segment Reporting	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Segment Reporting	(6) Segment Reporting Our reportable operating segments consist of acute care hospital services and behavioral health care services. The “Other” segment column below includes centralized services including, but not limited to, information technology, purchasing, reimbursement, accounting and finance, taxation, legal, advertising and design and construction. The chief operating decision making group for our acute care services and behavioral health care services is comprised of our Chief Executive Officer, the President and the Presidents of each operating segment. The Presidents for each operating segment also manage the profitability of each respective segment’s various facilities. The operating segments are managed separately because each operating segment represents a business unit that offers different types of healthcare services or operates in different healthcare environments. The accounting policies of the operating segments are the same as those described in the summary of significant accounting policies included in our Annual Report on Form 10-K for the year ended December 31, 2017. The corporate overhead allocations, as reflected below, are utilized for internal reporting purposes and are comprised of each period’s projected corporate-level operating expenses (excluding interest expense). The overhead expenses are captured and allocated directly to each segment to the extent possible, and overhead expenses incurred on behalf of both segments are captured and allocated to each segment based upon each segment’s respective percentage of total operating expenses. Three months ended March 31, 2018 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 6,361,766 $ 2,402,258 $ 0 $ 8,764,024 Gross outpatient revenues $ 3,714,661 $ 255,181 $ 0 $ 3,969,842 Total net revenues $ 1,445,632 $ 1,237,996 $ 3,888 $ 2,687,516 Income/(loss) before allocation of corporate overhead and income taxes $ 203,711 $ 238,748 $ (146,221 ) $ 296,238 Allocation of corporate overhead $ (49,891 ) $ (40,332 ) $ 90,223 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 153,820 $ 198,416 $ (55,998 ) $ 296,238 Total assets as of March 31, 2018 $ 3,924,302 $ 6,649,732 $ 449,483 $ 11,023,517 Three months ended March 31, 2017 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 5,597,850 $ 2,183,002 $ 0 $ 7,780,852 Gross outpatient revenues $ 3,294,177 $ 246,460 $ 0 $ 3,540,637 Total net revenues $ 1,389,547 $ 1,218,122 $ 5,189 $ 2,612,858 Income/(loss) before allocation of corporate overhead and income taxes $ 187,804 $ 251,931 $ (121,309 ) $ 318,426 Allocation of corporate overhead $ (45,676 ) $ (39,661 ) $ 85,337 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 142,128 $ 212,270 $ (35,972 ) $ 318,426 Total assets as of March 31, 2017 $ 3,757,311 $ 6,517,608 $ 173,340 $ 10,448,259 (a) Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $115 million and $100 million for the three-month periods ended March 31, 2018 and 2017, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1.176 billion and $992 million as of March 31, 2018 and 2017, respectively.

Earnings Per Share Data ("EPS")

Earnings Per Share Data ("EPS") and Stock Based Compensation	3 Months Ended
	Mar. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Earnings Per Share Data ("EPS") and Stock Based Compensation	(7) Earnings Per Share Data (“EPS”) and Stock Based Compensation Basic earnings per share are based on the weighted average number of common shares outstanding during the period. Diluted earnings per share are based on the weighted average number of common shares outstanding during the period adjusted to give effect to common stock equivalents. The following table sets forth the computation of basic and diluted earnings per share for classes A, B, C and D common stockholders for the periods indicated (in thousands, except per share data): Three months ended March 31, 2018 2017 Basic and Diluted: Net income attributable to UHS $ 223,832 $ 206,055 Less: Net income attributable to unvested restricted share grants (104 ) (94 ) Net income attributable to UHS – basic and diluted $ 223,728 $ 205,961 Weighted average number of common shares - basic 94,226 96,585 Net effect of dilutive stock options and grants based on the treasury stock method 457 787 Weighted average number of common shares and equivalents - diluted 94,683 97,372 Earnings per basic share attributable to UHS: $ 2.37 $ 2.13 Earnings per diluted share attributable to UHS: $ 2.36 $ 2.12 The “Net effect of dilutive stock options and grants based on the treasury stock method”, for all periods presented above, excludes certain outstanding stock options applicable to each period since the effect would have been anti-dilutive. The excluded weighted-average stock options totaled 2.9 million for the three months ended March 31, 2018. The excluded weighted-average stock options totaled 5.7 million for the three months ended March 31, 2017. All classes of our common stock have the same dividend rights. Stock-Based Compensation: During the three-month periods ended March 31, 2018 and 2017, pre-tax compensation cost of $18.9 million and $14.9 million, respectively, was recognized related to outstanding stock options. In addition, during the three-month periods ended March 31, 2018 and 2017, pre-tax compensation cost of approximately $545,000 and $150,000 (net of cancellations), respectively, was recognized related to restricted stock. As of March 31, 2018 there was approximately $87.0 million of unrecognized compensation cost related to unvested options and restricted stock which is expected to be recognized over the remaining weighted average vesting period of 2.4 years. There were 4,000 stock options granted during the first three months of 2018 with a weighted-average grant date fair value of $29.6425 per share. There were 16,926 shares of restricted shares granted during the first three months of 2018 with a weighted-average grant date fair value of $117.98 per share. The expense associated with stock-based compensation arrangements is a non-cash charge. In the Condensed Consolidated Statements of Cash Flows, stock-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities and aggregated to $19.7 million and $15.3 million during the three-month periods ended March 31, 2018 and 2017, respectively.

Dispositions and acquisitions

Dispositions and acquisitions	3 Months Ended
	Mar. 31, 2018
Business Combinations [Abstract]
Dispositions and acquisitions	(8) Dispositions and acquisitions Three-month period ended March 31, 2018: Acquisitions: During the first quarter of 2018, we paid approximately $21 million to acquire businesses and property consisting primarily of the acquisition of a 109-bed behavioral health care facility located in Gulfport, Mississippi. Divestitures: During the first quarter of 2018, there were no significant divestitures. Three-month period ended March 31, 2017: Acquisitions: During the first quarter of 2017, we paid approximately $18 million to acquire various property assets. Divestitures: During the first quarter of 2017, there were no divestitures.

Dividends

Dividends	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Dividends	(9) Dividends We declared and paid dividends of $9.4 million, or $.10 per share, during the first quarter of 2018 and $9.7 million or $.10 per share during the first quarter of 2017.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	(10) Income Taxes Our effective income tax rate was 22.8% for the three months ended March 31, 2018, compared with 33.9% for the three months ended March 31, 2017. The decrease in the effective tax rates for the three months ended March 31, 2018, compared with the same period in 2017, was primarily due to the Tax Cuts and Jobs Act of 2017 (the “TCJA-17”), which reduced the U.S. federal corporate tax rate from 35% to 21% effective January 1, 2018, partially offset by a $5 million increase in our provision for income taxes due to an unfavorable change resulting from our January 1, 2017 adoption of ASU 2016-09,“Compensation – Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting”, which decreased our provision for income taxes by $2 million during the first quarter of 2018 as compared to $7 million during the first quarter 2017. The TCJA-17 enacted on December 22, 2017 makes broad and complex changes to the U.S. tax code, including, but not limited to, (1) reducing the U.S. federal corporate tax rate from 35% to 21%; (2) requiring companies to pay a one-time transition tax on certain unrepatriated earnings of foreign subsidiaries; (3) generally eliminating U.S. federal income taxes on dividends from foreign subsidiaries; (4) requiring a current inclusion in U.S. federal taxable income of certain earnings of controlled foreign corporations through the implementation of a territorial tax system; and (5) creating a new limitation on deductible interest expense. Due to the complexities involved in accounting for the TCJA-17, the SEC issued Staff Accounting Bulletin No. 118 (“SAB 118"), which allows a measurement period of up to one year after the enactment date of the TCJA-17 to finalize the recording of the related tax impacts. We applied the guidance in SAB 118 and at December 31, 2017, recorded provisional estimates to re-measure our deferred taxes using the new 21% rate ($30 million tax benefit) and to record an estimated transition tax ($11.3 million expense). During the three months ended March 31, 2018, w e have not made any additional measurement period adjustments related to the provisional estimates recorded at December 31, 2017. However, we are continuing to gather additional information to complete our accounting for these items and expect to complete our accounting within the prescribed measurement period. The global intangible low-taxed income (“GILTI”) provisions from the TCJA-17 require the inclusion of the earnings of certain foreign subsidiaries in excess of an acceptable rate of return on certain assets of the respective subsidiaries in our U.S. tax return for tax years beginning after December 31, 2017. We recorded an estimate in our effective tax rate for the three months ended March 31, 2018. Due to the complexities around the calculation we have not recorded any provisional deferred tax effects related to the GILTI tax and will not make an accounting policy election at this time with respect to deferred tax effects of GILTI for our consolidated financial statements three months ended March 31, 2018. As of January 1, 2018, our unrecognized tax benefits were approximately $1 million. The amount, if recognized, that would favorably affect the effective tax rate is approximately $1 million. During the three months ended March 31, 2018, changes to the estimated liabilities for uncertain tax positions (including accrued interest) relating to tax positions taken during prior and current periods did not have a material impact on our financial statements. We recognize accrued interest and penalties associated with uncertain tax positions as part of the tax provision. As of March 31, 2018, we have less than $1 million of accrued interest and penalties. The U.S. federal statute of limitations remains open for 2014 and subsequent years. Foreign and U.S. state and local jurisdictions have statutes of limitations generally ranging from 3 to 4 years. The statute of limitations on certain jurisdictions could expire within the next twelve months. It is reasonably possible that the amount of uncertain tax benefits will change during the next 12 months, however, it is anticipated that any such change, if it were to occur, would not have a material impact on our results of operations. We operate in multiple jurisdictions with varying tax laws. We are subject to audits by any of these taxing authorities. Our tax returns have been examined by the Internal Revenue Service (“IRS”) through the year ended December 31, 2006. We believe that adequate accruals have been provided for federal, foreign and state taxes.

Revenue

Revenue	3 Months Ended
	Mar. 31, 2018
Revenue From Contract With Customer [Abstract]
Revenue	(11) Revenue In May 2014 and March 2016, the FASB issued ASU 2014-09 and ASU 2016-08, “Revenue from Contracts with Customers (Topic 606)” and “Revenue from Contracts with Customers: Principal versus Agent Considerations (Reporting Revenue Gross versus Net)”, respectively, which provides guidance for revenue recognition. The standard’s core principle is that a company will recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. Under the new standards, our estimate for amounts not expected to be collected based on historical experience will continue to be recognized as a reduction to net revenue. However, subsequent changes in estimate of collectability due to a change in the financial status of a payor, for example a bankruptcy, will be recognized as bad debt expense in operating charges. The performance obligation is separately identifiable from other promises in the contract. As the performance obligations are met (i.e.: room, board, ancillary services, level of care), revenue is recognized based upon allocated transaction price. . In assessing collectability, we have elected the portfolio approach. This portfolio approach is being used as we have large volume of similar contracts with similar classes of customers. We reasonably expect that the effect of applying a portfolio approach to a group of contracts would not differ materially from considering each contract separately. Management’s judgment to group the contracts by portfolio is based on the payment behavior expected in each portfolio category. As a result, aggregating all of the contracts (which are at the patient level) by the particular payor or group of payors, will result in the recognition of the same amount of revenue as applying the analysis at the individual patient level. On January 1, 2018, we adopted the new accounting standard using the modified retrospective method. The information in comparative periods have not been restated and continues to be reported under the accounting standards in effect for those periods. In accordance with the new revenue standard requirements, the disclosure of the impact of adoption on our condensed consolidated income statement was as follows (in thousands): Balances Without As Adoption Effect 2018 Reported ASC 606 of Change Net Revenue before provision for doubtful accounts $ 2,931,527 Less: Provision for doubtful accounts 246,543 Net Revenues $ 2,687,516 $ 2,684,984 $ 2,532 Other operating expenses $ 620,819 $ 618,287 $ 2,532 We group our revenues into categories based on payment behaviors. Each component has its own reimbursement structure which allows us to disaggregate the revenue into categories that share the nature and timing of payments. The other patient revenue consists primarily of self-pay, government-funded non-Medicaid, and other. The following table disaggregates our revenue by major source for the three month periods ended March 31, 2018 and 2017 (in thousands): 2018 Acute Care Behavioral Health Other Total Medicare $ 342,718 24 % $ 142,527 12 % $ 485,245 18 % Managed Medicare 176,957 12 % 44,995 4 % 221,952 8 % Medicaid 105,966 7 % 177,336 14 % 283,302 11 % Managed Medicaid 111,277 8 % 230,776 19 % 342,053 13 % Managed Care (HMO and PPOs) 497,780 34 % 358,062 29 % 855,842 32 % UK Revenue 0 0 % 114,741 9 % 114,741 4 % Other patient revenue 112,570 8 % 116,985 9 % 229,555 9 % Other non-patient revenue 98,364 7 % 52,574 4 % 3,888 154,826 6 % Total Net Revenue $ 1,445,632 100 % $ 1,237,996 100 % $ 3,888 2,687,516 100 % 2017 Acute Care Behavioral Health Other Total Medicare $ 316,385 23 % $ 146,645 12 % $ 463,030 18 % Managed Medicare 144,047 10 % 36,674 3 % 180,721 7 % Medicaid 92,657 7 % 180,949 15 % 273,606 10 % Managed Medicaid 114,552 8 % 217,645 18 % 332,197 13 % Managed Care (HMO and PPOs) 477,266 34 % 355,338 29 % 832,604 32 % UK Revenue 0 0 % 100,022 8 % 100,022 4 % Other patient revenue 123,374 9 % 124,798 10 % 248,172 9 % Other non-patient revenue 121,266 9 % 56,051 5 % 5,189 182,506 7 % Total Net Revenue $ 1,389,547 100 % $ 1,218,122 100 % $ 5,189 2,612,858 100 %

Recent Accounting Standards

Recent Accounting Standards	3 Months Ended
	Mar. 31, 2018
Accounting Changes And Error Corrections [Abstract]
Recent Accounting Standards	(12) Recent Accounting Standards On January 1, 2018, we adopted ASU No. 2016-15, Classification of Certain Cash Receipts and Cash Payments Restricted Cash, In February, 2016, the FASB issued ASU 2016-02, “Leases (Topic 842): Amendments to the FASB Accounting Standards Codification (“Update 2016-02”) , In January, 2017, the FASB issued ASU No. 2017-04, “Intangibles-Goodwill and Other (Topic 350): Simplifying the Accounting for Goodwill Impairment” (“ASU 2017-04”), which removes the requirement to perform a hypothetical purchase price allocation to measure goodwill impairment. A goodwill impairment will now be the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. ASU 2017-04 is effective for the annual and interim periods beginning January 1, 2020 with early adoption permitted, and applied prospectively. We do not expect ASU 2017-04 to have a material impact on our financial statements. In August, 2017, the FASB issued ASU 2017-12, “Targeted Improvements to Accounting for Hedging Activities", which amends the accounting and presentation of certain hedging activities outlined in ASC 815 and is intended to more accurately present economic results of hedging activities. This update is effective for annual reporting periods beginning after December 15, 2018 with early adoption permitted. The adoption is required prospectively with a cumulative-effect adjustment. We are currently evaluating the impact of this ASU on our financial statements. In February, 2018, the FASB issued ASU 2018-02, “Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income”, which allows a reclassification from accumulated other comprehensive income to retained earnings for stranded tax effects resulting from the Tax Cuts and Jobs Act of 2017. This update is effective for annual reporting periods beginning after December 15, 2018 with early adoption permitted. We are currently evaluating the impact of this ASU on our financial statements. From time to time, new accounting guidance is issued by the FASB or other standard setting bodies that is adopted by the Company as of the effective date or, in some cases where early adoption is permitted, in advance of the effective date. The Company has assessed the recently issued guidance that is not yet effective and, unless otherwise indicated above, believes the new guidance will not have a material impact on our results of operations, cash flows or financial position.

Relationship with Universal H18

Relationship with Universal Health Realty Income Trust and Related Party Transactions (Tables)	3 Months Ended
	Mar. 31, 2018
Related Party Transactions [Abstract]
Remaining Renewal Options and Terms for Each of Three Hospital Facilities Leased from Trust	The table below details the renewal options and terms for each of our three acute care hospital facilities leased from the Trust: Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2021 10(a) Wellington Regional Medical Center $ 3,030,000 December, 2021 10(b) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2021 10(b) (a) We have two 5-year renewal options at existing lease rates (through 2031). (b) We have two 5-year renewal options at fair market value lease rates (2022 through 2031).

Treasury (Tables)

Treasury (Tables)	3 Months Ended
	Mar. 31, 2018
Equity [Abstract]
Summary of Cash, Cash Equivalents and Restricted Cash Reported In Condensed Consolidated Statements of Cash Flows	Cash, cash equivalents, and restricted cash as reported in the condensed consolidated statements of cash flows are presented separately on our condensed consolidated balance sheets as follow (in thousands): March 31, December 31, 2018 2017 Cash and cash equivalents $ 73,053 $ 74,423 Restricted cash (a) 93,163 92,874 Total cash, cash equivalents and restricted cash $ 166,216 $ 167,297 (a) Restricted cash, associated with an insurance subsidiary, is included in other assets on the accompanying consolidated balance sheet.

Segment Reporting (Tables)

Segment Reporting (Tables)	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Segment Reporting	Three months ended March 31, 2018 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 6,361,766 $ 2,402,258 $ 0 $ 8,764,024 Gross outpatient revenues $ 3,714,661 $ 255,181 $ 0 $ 3,969,842 Total net revenues $ 1,445,632 $ 1,237,996 $ 3,888 $ 2,687,516 Income/(loss) before allocation of corporate overhead and income taxes $ 203,711 $ 238,748 $ (146,221 ) $ 296,238 Allocation of corporate overhead $ (49,891 ) $ (40,332 ) $ 90,223 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 153,820 $ 198,416 $ (55,998 ) $ 296,238 Total assets as of March 31, 2018 $ 3,924,302 $ 6,649,732 $ 449,483 $ 11,023,517 Three months ended March 31, 2017 Acute Care Hospital Services Behavioral Health Services (a) Other Total Consolidated (Amounts in thousands) Gross inpatient revenues $ 5,597,850 $ 2,183,002 $ 0 $ 7,780,852 Gross outpatient revenues $ 3,294,177 $ 246,460 $ 0 $ 3,540,637 Total net revenues $ 1,389,547 $ 1,218,122 $ 5,189 $ 2,612,858 Income/(loss) before allocation of corporate overhead and income taxes $ 187,804 $ 251,931 $ (121,309 ) $ 318,426 Allocation of corporate overhead $ (45,676 ) $ (39,661 ) $ 85,337 $ 0 Income/(loss) after allocation of corporate overhead and before income taxes $ 142,128 $ 212,270 $ (35,972 ) $ 318,426 Total assets as of March 31, 2017 $ 3,757,311 $ 6,517,608 $ 173,340 $ 10,448,259 (a) Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $115 million and $100 million for the three-month periods ended March 31, 2018 and 2017, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1.176 billion and $992 million as of March 31, 2018 and 2017, respectively.

Earnings Per Share Data ("EPS21

Earnings Per Share Data ("EPS") and Stock Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Computation of Basic and Diluted Earnings per Share for Classes A, B, C and D Common Stockholders	The following table sets forth the computation of basic and diluted earnings per share for classes A, B, C and D common stockholders for the periods indicated (in thousands, except per share data): Three months ended March 31, 2018 2017 Basic and Diluted: Net income attributable to UHS $ 223,832 $ 206,055 Less: Net income attributable to unvested restricted share grants (104 ) (94 ) Net income attributable to UHS – basic and diluted $ 223,728 $ 205,961 Weighted average number of common shares - basic 94,226 96,585 Net effect of dilutive stock options and grants based on the treasury stock method 457 787 Weighted average number of common shares and equivalents - diluted 94,683 97,372 Earnings per basic share attributable to UHS: $ 2.37 $ 2.13 Earnings per diluted share attributable to UHS: $ 2.36 $ 2.12

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2018
Schedule of Disaggregates Revenue by Major Source	The following table disaggregates our revenue by major source for the three month periods ended March 31, 2018 and 2017 (in thousands): 2018 Acute Care Behavioral Health Other Total Medicare $ 342,718 24 % $ 142,527 12 % $ 485,245 18 % Managed Medicare 176,957 12 % 44,995 4 % 221,952 8 % Medicaid 105,966 7 % 177,336 14 % 283,302 11 % Managed Medicaid 111,277 8 % 230,776 19 % 342,053 13 % Managed Care (HMO and PPOs) 497,780 34 % 358,062 29 % 855,842 32 % UK Revenue 0 0 % 114,741 9 % 114,741 4 % Other patient revenue 112,570 8 % 116,985 9 % 229,555 9 % Other non-patient revenue 98,364 7 % 52,574 4 % 3,888 154,826 6 % Total Net Revenue $ 1,445,632 100 % $ 1,237,996 100 % $ 3,888 2,687,516 100 % 2017 Acute Care Behavioral Health Other Total Medicare $ 316,385 23 % $ 146,645 12 % $ 463,030 18 % Managed Medicare 144,047 10 % 36,674 3 % 180,721 7 % Medicaid 92,657 7 % 180,949 15 % 273,606 10 % Managed Medicaid 114,552 8 % 217,645 18 % 332,197 13 % Managed Care (HMO and PPOs) 477,266 34 % 355,338 29 % 832,604 32 % UK Revenue 0 0 % 100,022 8 % 100,022 4 % Other patient revenue 123,374 9 % 124,798 10 % 248,172 9 % Other non-patient revenue 121,266 9 % 56,051 5 % 5,189 182,506 7 % Total Net Revenue $ 1,389,547 100 % $ 1,218,122 100 % $ 5,189 2,612,858 100 %
ASU 2014-09
Schedule of Impact of Adoption on Condensed Consolidated Income Statement	On January 1, 2018, we adopted the new accounting standard using the modified retrospective method. The information in comparative periods have not been restated and continues to be reported under the accounting standards in effect for those periods. In accordance with the new revenue standard requirements, the disclosure of the impact of adoption on our condensed consolidated income statement was as follows (in thousands): Balances Without As Adoption Effect 2018 Reported ASC 606 of Change Net Revenue before provision for doubtful accounts $ 2,931,527 Less: Provision for doubtful accounts 246,543 Net Revenues $ 2,687,516 $ 2,684,984 $ 2,532 Other operating expenses $ 620,819 $ 618,287 $ 2,532

Relationship with Universal H23

Relationship with Universal Health Realty Income Trust and Related Party Transactions - Additional Information (Detail)	3 Months Ended			12 Months Ended
	Mar. 31, 2018USD ($)HospitalFacility	Mar. 31, 2017USD ($)Hospital	Dec. 31, 2013	Dec. 31, 2017USD ($)
Chief Executive Officer
Related Party Transaction [Line Items]
Estimated payments to acquire life insurance policies	$ 28,000,000
Payments to acquire life insurance policies	1,100,000	$ 1,200,000
Chief Executive Officer | Trust Owned by CEO
Related Party Transaction [Line Items]
Estimated payments to acquire life insurance policies	9,000,000
Minimum | Chief Executive Officer
Related Party Transaction [Line Items]
Estimated death benefit proceeds	$ 37,000,000
Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Trust outstanding shares held, percentage	5.70%
Advisory fee earned	$ 900,000	900,000
Pre-tax share of income from the Trust	284,000	1,800,000
Carrying value of investment in Trust	8,500,000			$ 8,200,000
Market value of investment in Trust	$ 47,300,000			59,200,000
Lease renewal period, years	5 years
Rent expense under operating leases	$ 4,000,000	$ 4,000,000
Notice period on renewal of lease	90 days
Period of rights of refusal to leased facilities	180 days
Number of hospital facilities | Hospital	3	3
Number of free-standing emergency departments to be acquired | Facility	2
Relationship with Universal Health Realty Income Trust | Minimum
Related Party Transaction [Line Items]
Lease initial terms	13 years
Non-controlling ownership interests by subsidiaries	95.00%
Relationship with Universal Health Realty Income Trust | Maximum
Related Party Transaction [Line Items]
Lease initial terms	15 years
Non-controlling ownership interests by subsidiaries	100.00%
Premier, Inc. | Group Purchasing Organization Agreement | Restricted Stock
Related Party Transaction [Line Items]
Shares vesting period			7 years
Shares vesting period start year			2,014
Shares vesting period end year			2,020
Market value of retained vested shares	$ 35,000,000			$ 33,000,000

Remaining Renewal Options and T

Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Detail)	3 Months Ended
	Mar. 31, 2018USD ($)
McAllen Medical Center
Property Subject to or Available for Operating Lease [Line Items]
Annual Minimum Rent	$ 5,485,000
End of Lease Term	2021-12
Renewal Term (years)	10 years	[1]
Wellington Regional Medical Center
Property Subject to or Available for Operating Lease [Line Items]
Annual Minimum Rent	$ 3,030,000
End of Lease Term	2021-12
Renewal Term (years)	10 years	[2]
Southwest Healthcare System, Inland Valley Campus
Property Subject to or Available for Operating Lease [Line Items]
Annual Minimum Rent	$ 2,648,000
End of Lease Term	2021-12
Renewal Term (years)	10 years	[2]
[1]	We have two 5-year renewal options at existing lease rates (through 2031).
[2]	We have two 5-year renewal options at fair market value lease rates (2022 through 2031).

Remaining Renewal Options and25

Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2018RenewalOption
McAllen Medical Center
Property Subject to or Available for Operating Lease [Line Items]
Number of renewal options at existing lease rates	2
Renewal options term at existing lease rates	5 years
McAllen Medical Center | Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at existing lease rates expiration year	2,031
Wellington Regional Medical Center
Property Subject to or Available for Operating Lease [Line Items]
Number of renewal options at fair market lease rates	2
Renewal options term at fair market lease rates	5 years
Wellington Regional Medical Center | Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year	2,031
Wellington Regional Medical Center | Minimum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year	2,022
Southwest Healthcare System, Inland Valley Campus
Property Subject to or Available for Operating Lease [Line Items]
Number of renewal options at fair market lease rates	2
Renewal options term at fair market lease rates	5 years
Southwest Healthcare System, Inland Valley Campus | Maximum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year	2,031
Southwest Healthcare System, Inland Valley Campus | Minimum
Property Subject to or Available for Operating Lease [Line Items]
Renewal options at fair market value lease rates expiration year	2,022

Other Noncurrent Liabilities 26

Other Noncurrent Liabilities and Redeemable/Noncontrolling Interests - Additional Information (Detail) $ in Millions	Mar. 31, 2018USD ($)Facility
Minority Interest [Line Items]
Behavioral health care facilities with outside owners holding non-controlling minority interest | Facility	2
Non-controlling interest balances	$ 70
Redeemable non-controlling interest balances	$ 6
Acute Care Facilities | Washington, District of Columbia
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	20.00%
Acute Care Facilities | Texas
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	11.00%
Acute Care Facilities | Nevada
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	5.00%
Behavioral Health Services | Pennsylvania
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	20.00%
Behavioral Health Services | Ohio
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	30.00%
Behavioral Health Services | Washington
Minority Interest [Line Items]
Percentage of non-controlling, minority ownership interests held by outside owners	20.00%

Treasury - Additional Informati

Treasury - Additional Information (Detail)

Jun. 07, 2016USD ($)

May 31, 2015USD ($)Derivative

Apr. 30, 2018USD ($)

Mar. 31, 2018USD ($)

Mar. 31, 2017USD ($)

Dec. 31, 2015USD ($)Derivative

Sep. 30, 2015USD ($)Derivative

Jun. 30, 2015USD ($)Derivative

Dec. 31, 2014USD ($)

Sep. 30, 2017USD ($)

Dec. 31, 2015USD ($)Derivative

Dec. 31, 2017USD ($)

Jun. 03, 2016USD ($)

Aug. 07, 2014USD ($)

Equity Class Of Treasury Stock [Line Items]

Line of credit facility, starting date

Jun. 7, 2016

Line of credit facility, maturity month

2019-08

Rate adjustment to weighted average federal funds rate for credit facility borrowings

0.50%

Rate adjustment to one month Eurodollar rate on credit facility borrowings

1.00%

Accounts receivable securitization program credit facility, borrowing capacity

$ 440,000,000

Accounts receivable securitization program credit facility, amount outstanding

440,000,000

Accounts receivable securitization program credit facility, available borrowing capacity

0

Debt instrument carrying amount

3,900,000,000

$ 4,000,000,000

Fair value of debt

3,900,000,000

4,100,000,000

Number of additional forward starting interest rate swaps | Derivative

4

Previously Outstanding Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Maturity date of interest rate cash flow hedges

May 31, 2015

One Point Three One Percent Forward Starting Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Maturity date of interest rate cash flow hedges

Apr. 15, 2019

Number of additional forward starting interest rate swaps | Derivative

9

Fixed rate payable on interest rate swap

1.31%

1.31%

One Point Four Zero Percent Forward Starting Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Maturity date of interest rate cash flow hedges

Apr. 15, 2019

Number of additional forward starting interest rate swaps | Derivative

4

Average fixed rate payable on interest rate swap

1.40%

One Point Two Three Percent Forward Starting Interest Rate Swaps One

Equity Class Of Treasury Stock [Line Items]

Maturity date of interest rate cash flow hedges

Apr. 15, 2019

Average fixed rate payable on interest rate swap

1.23%

One Point Two One Percent Forward Starting Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Maturity date of interest rate cash flow hedges

Apr. 15, 2019

Number of additional forward starting interest rate swaps | Derivative

1

Fixed rate payable on interest rate swap

1.21%

1.21%

Interest Rate Swap

Equity Class Of Treasury Stock [Line Items]

Fair value of our interest rate swaps

9,000,000

7,000,000

Interest Rate Swap | Net Accounts Receivable

Equity Class Of Treasury Stock [Line Items]

Fair value of our interest rate swaps, assets

8,000,000

4,000,000

Interest Rate Swap | Other Assets

Equity Class Of Treasury Stock [Line Items]

Fair value of our interest rate swaps, assets

1,000,000

$ 3,000,000

Foreign Currency Forward Exchange Contracts

Equity Class Of Treasury Stock [Line Items]

Net cash outflows

(46,000,000)

$ (8,000,000)

Cash Flow Hedging | Previously Outstanding Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Number of interest rate swaps | Derivative

7

Notional amount of interest rate cash flow hedges

$ 825,000,000

Cash Flow Hedging | One Point Three One Percent Forward Starting Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Notional amount of interest rate cash flow hedges

$ 1,000,000,000

$ 1,000,000,000

Cash Flow Hedging | One Point Four Zero Percent Forward Starting Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Notional amount of interest rate cash flow hedges

$ 500,000,000

Cash Flow Hedging | Forward Starting Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Notional amount of interest rate cash flow hedges

$ 400,000,000

Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps One

Equity Class Of Treasury Stock [Line Items]

Notional amount of interest rate cash flow hedges

100,000,000

Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps Two

Equity Class Of Treasury Stock [Line Items]

Notional amount of interest rate cash flow hedges

200,000,000

Cash Flow Hedging | One Point Two Three Percent Forward Starting Interest Rate Swaps Three

Equity Class Of Treasury Stock [Line Items]

Notional amount of interest rate cash flow hedges

$ 100,000,000

Cash Flow Hedging | One Point Two One Percent Forward Starting Interest Rate Swaps

Equity Class Of Treasury Stock [Line Items]

Notional amount of interest rate cash flow hedges

$ 100,000,000

$ 100,000,000

Subsequent Event

Equity Class Of Treasury Stock [Line Items]

Line of credit facility increased amount

$ 10,000,000

Accounts receivable securitization program credit facility, borrowing capacity

$ 450,000,000

Revolving Credit Facility

Equity Class Of Treasury Stock [Line Items]

Line of credit facility, borrowing capacity

$ 800,000,000

800,000,000

Line of credit facility amount outstanding

$ 285,000,000

Current applicable margins

1.50%

Line of credit facility, available borrowing capacity

$ 446,000,000

Letters of credit, outstanding

34,000,000

Revolving Credit Facility | Short Term on Demand Credit Facility

Equity Class Of Treasury Stock [Line Items]

Line of credit facility amount outstanding

35,000,000

Revolving Credit Facility | Letter of Credit

Equity Class Of Treasury Stock [Line Items]

Line of credit facility, borrowing capacity

$ 125,000,000

Revolving Credit Facility | ABR-based loans

Equity Class Of Treasury Stock [Line Items]

Current applicable margins

0.50%

Revolving Credit Facility | Minimum | One Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

0.50%

Revolving Credit Facility | Minimum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

1.50%

Revolving Credit Facility | Maximum | One Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

1.25%

Revolving Credit Facility | Maximum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

2.25%

Term Loan A

Equity Class Of Treasury Stock [Line Items]

Line of credit facility amount outstanding

$ 1,753,000,000

Line of credit facility increased amount

$ 200,000,000

Current applicable margins

1.50%

Term Loan A | Quarterly installment payments made from the fourth quarter of 2014 through third quarter of 2016

Equity Class Of Treasury Stock [Line Items]

Scheduled principal payments made

$ 11,000,000

Term Loan A | Quarterly installment payments after September, 2016

Equity Class Of Treasury Stock [Line Items]

Scheduled principal payments made

$ 22,000,000

Term Loan A | ABR-based loans

Equity Class Of Treasury Stock [Line Items]

Current applicable margins

0.50%

Term Loan A | Minimum | One Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

0.50%

Term Loan A | Minimum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

1.50%

Term Loan A | Maximum | One Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

1.25%

Term Loan A | Maximum | One Two Three Six Month Eurodollar Rate Plus Index Based Loans

Equity Class Of Treasury Stock [Line Items]

Consolidated Leverage Ratio

2.25%

New Senior Secured Notes

Equity Class Of Treasury Stock [Line Items]

Senior notes, issued

$ 1,400,000,000

New Senior Secured Notes | 3.75% Senior Secured Notes due 2019

Equity Class Of Treasury Stock [Line Items]

Senior notes, issued

$ 300,000,000

Senior notes, interest rate

3.75%

Senior notes, maturity date

Aug. 1, 2019

New Senior Secured Notes | 4.75% Senior Secured Notes due 2022

Equity Class Of Treasury Stock [Line Items]

Senior notes, issued

$ 700,000,000

$ 400,000,000

$ 300,000,000

Senior notes, interest rate

4.75%

Senior notes issued percentage

101.50%

Senior notes yield percentage

4.35%

Senior notes, maturity date

Aug. 1, 2022

New Senior Secured Notes | 5.00% Senior Secured Notes due 2026

Equity Class Of Treasury Stock [Line Items]

Senior notes, issued

$ 400,000,000

Senior notes, interest rate

5.00%

Senior notes, maturity date

Jun. 1, 2026

Summary of Cash, Cash Equivalen

Summary of Cash, Cash Equivalents and Restricted Cash Reported In Condensed Consolidated Statements of Cash Flows (Detail) - USD ($) $ in Thousands		Mar. 31, 2018	Dec. 31, 2017	Mar. 31, 2017	Dec. 31, 2016
Cash And Cash Equivalents Period Increase Decrease [Abstract]
Cash and cash equivalents		$ 73,053	$ 74,423
Restricted cash	[1]	93,163	92,874
Total cash, cash equivalents and restricted cash		$ 166,216	$ 167,297	$ 151,278	$ 121,950
[1]	Restricted cash, associated with an insurance subsidiary, is included in other assets on the accompanying consolidated balance sheet.

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) £ in Millions	3 Months Ended		12 Months Ended			48 Months Ended
	Mar. 31, 2018USD ($)	Mar. 31, 2018GBP (£)	Dec. 31, 2013USD ($)	Dec. 31, 2012USD ($)	Dec. 31, 2011USD ($)Hospital	Mar. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Jan. 31, 2017USD ($)	Jan. 31, 2017GBP (£)	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability, current	$ 54,000,000					$ 54,000,000	$ 54,000,000
Compensation liability claims	70,000,000					70,000,000	70,000,000
Compensation and related benefits	35,000,000					35,000,000	35,000,000
Accounts receivable, net	1,569,803,000					1,569,803,000	1,500,898,000
Department of Human Services
Commitments and Contingencies Disclosure [Line Items]
Repayment of legal settlement amount on demand			$ 11,000,000	$ 11,000,000	$ 4,000,000
McAllen Medical Center
Commitments and Contingencies Disclosure [Line Items]
Amount awarded to plaintiff	3,850,000
Total amount of order, including prejudgment interest	9,000,000
DOJ
Commitments and Contingencies Disclosure [Line Items]
Pre-tax increase to reserve for civil aspects	13,000,000
Increase in aggregate pre-tax reserve	35,000,000
River Point Behavioral Health
Commitments and Contingencies Disclosure [Line Items]
Amount withheld in contingent medicare payment suspension						10,000,000
Letters of Credit and Surety Bonds
Commitments and Contingencies Disclosure [Line Items]
Off-balance sheet contingent obligation	117,000,000					117,000,000
Self Insurance Programs | Letters of Credit and Surety Bonds
Commitments and Contingencies Disclosure [Line Items]
Off-balance sheet contingent obligation	108,000,000					108,000,000
Other Debt Guarantees | Letters of Credit and Surety Bonds
Commitments and Contingencies Disclosure [Line Items]
Off-balance sheet contingent obligation	9,000,000					9,000,000
Illinois
Commitments and Contingencies Disclosure [Line Items]
Accounts receivable, net	35,000,000					35,000,000	25,000,000
Accounts receivable net greater than sixty days Past due	15,000,000					15,000,000	8,000,000
Pennsylvania | Department of Human Services
Commitments and Contingencies Disclosure [Line Items]
Number of behavioral health care hospitals | Hospital					7
Wind Storms
Commitments and Contingencies Disclosure [Line Items]
Minimum Insurance Deductible	50,000					50,000
Maximum insurance deductible	250,000					250,000
Flood
Commitments and Contingencies Disclosure [Line Items]
Maximum insurance deductible	500,000					500,000
Cygnet Health Care Limited
Commitments and Contingencies Disclosure [Line Items]
Property insurance | £		£ 1,290
Maximum | Wind Storms
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses	$ 1,000,000,000					$ 1,000,000,000
Percentage of insurance deductible	5.00%					5.00%
Maximum | Earthquake | LAS VEGAS, NEVADA
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses	$ 500,000,000					$ 500,000,000
Maximum | Earthquake | CALIFORNIA
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses	130,000,000					130,000,000
Maximum | Earthquake | Faulty Zones of UNITED STATES
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses	100,000,000					100,000,000
Maximum | Earthquake | PUERTO RICO
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses	40,000,000					40,000,000
Maximum | Earthquake | OTHER STATES
Commitments and Contingencies Disclosure [Line Items]
Commercial property insurance policies covering catastrophic losses	$ 250,000,000					$ 250,000,000
Minimum | Wind Storms
Commitments and Contingencies Disclosure [Line Items]
Percentage of insurance deductible	3.00%					3.00%
General and Professional Liability
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability	$ 232,000,000					$ 232,000,000	$ 229,000,000
Subsidiaries | Professional Liability | Cygnet Health Care Limited
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability | £									£ 10
Subsidiaries | Professional Liability | Maximum
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability								$ 5,000,000		$ 10,000,000
Subsidiaries | General Liability | Cygnet Health Care Limited
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability | £									£ 25
Subsidiaries | General Liability | Maximum
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability								$ 3,000,000		3,000,000
Subsidiaries | General And Professional Liability Insurance Policies
Commitments and Contingencies Disclosure [Line Items]
Percentage of liability for claims paid under commercially insured coverage	10.00%					10.00%
Subsidiaries | General And Professional Liability Insurance Policies | Maximum
Commitments and Contingencies Disclosure [Line Items]
Purchased several excess policies through commercial insurance carriers per occurrence			$ 200,000,000							$ 250,000,000	$ 250,000,000	$ 250,000,000
Liability for claims paid under commercially insured coverage	$ 5,000,000					$ 5,000,000

Segment Reporting (Detail)

Segment Reporting (Detail) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Segment Reporting Information [Line Items]
Gross inpatient revenues		$ 8,764,024	$ 7,780,852
Gross outpatient revenues		3,969,842	3,540,637
Total net revenues		2,687,516	2,612,858
Income/(loss) before allocation of corporate overhead and income taxes		296,238	318,426
Allocation of corporate overhead		0	0
Income/(loss) after allocation of corporate overhead and before income taxes		296,238	318,426
Total assets		11,023,517	10,448,259	$ 10,761,828
Acute Care Hospital Services
Segment Reporting Information [Line Items]
Gross inpatient revenues		6,361,766	5,597,850
Gross outpatient revenues		3,714,661	3,294,177
Total net revenues		1,445,632	1,389,547
Income/(loss) before allocation of corporate overhead and income taxes		203,711	187,804
Allocation of corporate overhead		(49,891)	(45,676)
Income/(loss) after allocation of corporate overhead and before income taxes		153,820	142,128
Total assets		3,924,302	3,757,311
Behavioral Health Services
Segment Reporting Information [Line Items]
Gross inpatient revenues	[1]	2,402,258	2,183,002
Gross outpatient revenues	[1]	255,181	246,460
Total net revenues	[1]	1,237,996	1,218,122
Income/(loss) before allocation of corporate overhead and income taxes	[1]	238,748	251,931
Allocation of corporate overhead	[1]	(40,332)	(39,661)
Income/(loss) after allocation of corporate overhead and before income taxes	[1]	198,416	212,270
Total assets	[1]	6,649,732	6,517,608
Other
Segment Reporting Information [Line Items]
Gross inpatient revenues		0	0
Gross outpatient revenues		0	0
Total net revenues		3,888	5,189
Income/(loss) before allocation of corporate overhead and income taxes		(146,221)	(121,309)
Allocation of corporate overhead		90,223	85,337
Income/(loss) after allocation of corporate overhead and before income taxes		(55,998)	(35,972)
Total assets		$ 449,483	$ 173,340
[1]	Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $115 million and $100 million for the three-month periods ended March 31, 2018 and 2017, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1.176 billion and $992 million as of March 31, 2018 and 2017, respectively.

Segment Reporting (Parenthetica

Segment Reporting (Parenthetical) (Detail) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Segment Reporting Information [Line Items]
Net revenues		$ 2,687,516	$ 2,612,858
Total assets		11,023,517	10,448,259	$ 10,761,828
Behavioral Health Services
Segment Reporting Information [Line Items]
Net revenues	[1]	1,237,996	1,218,122
Total assets	[1]	6,649,732	6,517,608
Behavioral Health Services | Located in U.K.
Segment Reporting Information [Line Items]
Net revenues		115,000	100,000
Total assets		$ 1,176,000	$ 992,000
[1]	Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $115 million and $100 million for the three-month periods ended March 31, 2018 and 2017, respectively. Total assets at our U.K. behavioral health care facilities were approximately $1.176 billion and $992 million as of March 31, 2018 and 2017, respectively.

Computation of Basic and Dilute

Computation of Basic and Diluted Earnings Per Share for classes A, B, C and D Common Stockholders (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Basic and Diluted:
Net income attributable to UHS	$ 223,832	$ 206,055
Less: Net income attributable to unvested restricted share grants	(104)	(94)
Net income attributable to UHS – basic and diluted	$ 223,728	$ 205,961
Weighted average number of common shares - basic	94,226	96,585
Net effect of dilutive stock options and grants based on the treasury stock method	457	787
Weighted average number of common shares and equivalents - diluted	94,683	97,372
Earnings per basic share attributable to UHS:	$ 2.37	$ 2.13
Earnings per diluted share attributable to UHS:	$ 2.36	$ 2.12

Earnings Per Share Data ("EPS33

Earnings Per Share Data ("EPS") and Stock Based Compensation - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Anti-dilutive weighted average stock options excluded from computation of earnings per share	2,900,000	5,700,000
Stock options granted during period	4,000
Weighted-average grant date fair value, per share	$ 29.6425
Compensation cost recognized	$ 19,700,000	$ 15,348,000
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost recognized, pre-tax charge	18,900,000	14,900,000
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost recognized, pre-tax charge	545,000	$ 150,000
Unrecognized compensation cost	$ 87,000,000
Unrecognized compensation cost vesting period	2 years 4 months 24 days
Restricted shares granted during period	16,926,000
Weighted-average grant date fair value, per share	$ 117.98
Unvested Stock option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 87,000,000
Unrecognized compensation cost vesting period	2 years 4 months 24 days

Dispositions and Acquisitions -

Dispositions and Acquisitions - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2018USD ($)Bed	Mar. 31, 2017USD ($)
Business Acquisition [Line Items]
Acquisition, cash paid	$ 21,000,000	$ 18,000,000
Aggregate cash proceeds from divestiture of businesses	$ 0	$ 0
Gulfport Behavioral Health System
Business Acquisition [Line Items]
Number of beds | Bed	109

Dividends - Additional Informat

Dividends - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Dividends [Abstract]
Dividends declared and paid	$ 9.4	$ 9.7
Quarterly cash dividend	$ 0.10	$ 0.10

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017	Jan. 01, 2018
Income Taxes [Line Items]
Effective income tax rate	22.80%	33.90%
Reduction in corporate tax rate	21.00%		35.00%
Tax code changes description	The TCJA-17 enacted on December 22, 2017 makes broad and complex changes to the U.S. tax code, including, but not limited to, (1) reducing the U.S. federal corporate tax rate from 35% to 21%; (2) requiring companies to pay a one-time transition tax on certain unrepatriated earnings of foreign subsidiaries; (3) generally eliminating U.S. federal income taxes on dividends from foreign subsidiaries; (4) requiring a current inclusion in U.S. federal taxable income of certain earnings of controlled foreign corporations through the implementation of a territorial tax system; and (5) creating a new limitation on deductible interest expense.
Income tax benefits	$ (67,569,000)	$ (107,899,000)	$ 30,000,000
Estimated transition tax obligations			11,300,000
Provisional deferred tax - GILTI	$ 0
Unrecognized tax benefits				$ 1,000,000
Impact of unrecognized tax benefits if recognized				$ 1,000,000
Period of expiration of the statute of limitations for certain jurisdictions	Within the next twelve months
Jurisdictions statutes of limitations expiration period	12 months
Minimum
Income Taxes [Line Items]
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years	3 years
Maximum
Income Taxes [Line Items]
Accrued interest and penalties	$ 1,000,000
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years	4 years
ASU 2016-09
Income Taxes [Line Items]
Increase (decrease) in provision for income taxes	$ (2,000,000)	$ (7,000,000)	$ 5,000,000

Schedule of Impact of Adoption

Schedule of Impact of Adoption on Condensed Consolidated Income Statement (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Disaggregation Of Revenue [Line Items]
Net Revenue before provision for doubtful accounts		$ 2,825,472
Less: Provision for doubtful accounts		212,614
Net Revenues	$ 2,687,516	2,612,858
Other operating expenses	620,819	$ 607,360
Balances Without Adoption ASC 606 | ASU 2014-09
Disaggregation Of Revenue [Line Items]
Net Revenue before provision for doubtful accounts	2,931,527
Less: Provision for doubtful accounts	246,543
Net Revenues	2,684,984
Other operating expenses	618,287
Effect of Change | ASU 2014-09
Disaggregation Of Revenue [Line Items]
Net Revenues	2,532
Other operating expenses	$ 2,532

Schedule of Disaggregates Reven

Schedule of Disaggregates Revenue by Major Source (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 2,687,516	$ 2,612,858
Percentage of Net Revenue	100.00%	100.00%
Medicare
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 485,245	$ 463,030
Percentage of Net Revenue	18.00%	18.00%
Managed Medicare
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 221,952	$ 180,721
Percentage of Net Revenue	8.00%	7.00%
Medicaid
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 283,302	$ 273,606
Percentage of Net Revenue	11.00%	10.00%
Managed Medicaid
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 342,053	$ 332,197
Percentage of Net Revenue	13.00%	13.00%
Managed Care (HMO and PPOs)
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 855,842	$ 832,604
Percentage of Net Revenue	32.00%	32.00%
UK Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 114,741	$ 100,022
Percentage of Net Revenue	4.00%	4.00%
Other Patient Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 229,555	$ 248,172
Percentage of Net Revenue	9.00%	9.00%
Other Non-patient Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 154,826	$ 182,506
Percentage of Net Revenue	6.00%	7.00%
Acute Care
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 1,445,632	$ 1,389,547
Percentage of Net Revenue	100.00%	100.00%
Acute Care | Medicare
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 342,718	$ 316,385
Percentage of Net Revenue	24.00%	23.00%
Acute Care | Managed Medicare
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 176,957	$ 144,047
Percentage of Net Revenue	12.00%	10.00%
Acute Care | Medicaid
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 105,966	$ 92,657
Percentage of Net Revenue	7.00%	7.00%
Acute Care | Managed Medicaid
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 111,277	$ 114,552
Percentage of Net Revenue	8.00%	8.00%
Acute Care | Managed Care (HMO and PPOs)
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 497,780	$ 477,266
Percentage of Net Revenue	34.00%	34.00%
Acute Care | UK Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 0	$ 0
Percentage of Net Revenue	0.00%	0.00%
Acute Care | Other Patient Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 112,570	$ 123,374
Percentage of Net Revenue	8.00%	9.00%
Acute Care | Other Non-patient Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 98,364	$ 121,266
Percentage of Net Revenue	7.00%	9.00%
Other
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 3,888	$ 5,189
Other | Other Non-patient Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	3,888	5,189
Behavioral Health
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 1,237,996	$ 1,218,122
Percentage of Net Revenue	100.00%	100.00%
Behavioral Health | Medicare
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 142,527	$ 146,645
Percentage of Net Revenue	12.00%	12.00%
Behavioral Health | Managed Medicare
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 44,995	$ 36,674
Percentage of Net Revenue	4.00%	3.00%
Behavioral Health | Medicaid
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 177,336	$ 180,949
Percentage of Net Revenue	14.00%	15.00%
Behavioral Health | Managed Medicaid
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 230,776	$ 217,645
Percentage of Net Revenue	19.00%	18.00%
Behavioral Health | Managed Care (HMO and PPOs)
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 358,062	$ 355,338
Percentage of Net Revenue	29.00%	29.00%
Behavioral Health | UK Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 114,741	$ 100,022
Percentage of Net Revenue	9.00%	8.00%
Behavioral Health | Other Patient Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 116,985	$ 124,798
Percentage of Net Revenue	9.00%	10.00%
Behavioral Health | Other Non-patient Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 52,574	$ 56,051
Percentage of Net Revenue	4.00%	5.00%