Document and Entity Information (USD $)	12 Months Ended
Document and Entity Information (USD $)	Dec. 31, 2013	Jun. 30, 2013	Jan. 31, 2014 Class A	Jan. 31, 2014 Class B	Jan. 31, 2014 Class C	Jan. 31, 2014 Class D
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2013
Document Fiscal Year Focus	2013
Document Fiscal Period Focus	FY
Trading Symbol	UHS
Entity Registrant Name	UNIVERSAL HEALTH SERVICES INC
Entity Central Index Key	0000352915
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding			6,595,708	91,321,038	664,000	29,983
Entity Public Float		$ 6,000,000,000

Consolidated Statements of Income (USD $) In Thousands, except Per Share data, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Net revenues before provision for doubtful accounts									$ 8,411,038	$ 7,688,071	$ 7,356,798
Less: Provision for doubtful accounts									1,127,216	726,671	596,576
Net revenues	1,800,846	1,816,369	1,834,975	1,831,632	1,764,927	1,680,353	1,723,084	1,793,036	7,283,822	6,961,400	6,760,222
Operating charges:
Salaries, wages and benefits									3,604,620	3,440,917	3,326,378
Other operating expenses									1,468,744	1,376,122	1,353,693
Supplies expense									821,089	799,621	805,489
Depreciation and amortization									337,172	302,426	287,211
Lease and rental expense									97,758	94,885	90,323
Transaction costs									0	5,716	0
Electronic health records incentive income									(61,024)	(30,038)	0
Costs related to extinguishment of debt									0	29,170	0
Operating Expenses, Total									6,268,359	6,018,819	5,863,094
Income from operations									1,015,463	942,581	897,128
Interest expense, net									146,131	178,918	200,792
Income before income taxes									869,332	763,663	696,336
Provision for income taxes									315,309	274,616	247,466
Net income	133,186	123,099	167,803	129,935	147,660	81,373	117,444	142,570	554,023	489,047	448,870
Less: Net income attributable to noncontrolling interests	8,665	8,512	15,962	10,151	12,199	9,556	9,883	13,963	43,290	45,601	50,703
Net income attributable to UHS	$ 124,521	$ 114,587	$ 151,841	$ 119,784	$ 135,461	$ 71,817	$ 107,561	$ 128,607	$ 510,733	$ 443,446	$ 398,167
Basic earnings per share attributable to UHS	$ 1.27	$ 1.17	$ 1.55	$ 1.23	$ 1.39	$ 0.74	$ 1.11	$ 1.33	$ 5.21	$ 4.57	$ 4.09
Diluted earnings per share attributable to UHS	$ 1.24	$ 1.15	$ 1.53	$ 1.21	$ 1.39	$ 0.73	$ 1.10	$ 1.31	$ 5.14	$ 4.53	$ 4.04
Weighted average number of common shares-basic									98,033	96,821	97,199
Add: Other share equivalents									1,328	890	1,338
Weighted average number of common shares and equivalents-diluted									99,361	97,711	98,537

Consolidated Statements of Comprehensive Income (USD $) In Thousands, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Net income	$ 133,186	$ 123,099	$ 167,803	$ 129,935	$ 147,660	$ 81,373	$ 117,444	$ 142,570	$ 554,023	$ 489,047	$ 448,870
Other comprehensive income (loss):
Unrealized derivative gains (losses) on cash flow hedges									16,963	6,677	(37,477)
Amortization of terminated hedge									(336)	(336)	(336)
Minimum Pension Liability									14,657	4,986	(12,397)
Other comprehensive income (loss) before tax									31,284	11,327	(50,210)
Income tax (benefit) expense related to items of other comprehensive income									11,940	4,306	(19,174)
Total other comprehensive income (loss), net of tax									19,344	7,021	(31,036)
Comprehensive income									573,367	496,068	417,834
Less: Comprehensive income attributable to noncontrolling interests									43,290	45,601	50,703
Comprehensive income attributable to UHS									$ 530,077	$ 450,467	$ 367,131

Consolidated Balance Sheets (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Current assets:
Cash and cash equivalents	$ 17,238	$ 23,471
Accounts receivable, net	1,116,961	1,067,197
Supplies	101,781	99,000
Deferred income taxes	119,903	104,461
Other current assets	76,446	87,936
Assets of facilities held for sale	0	25,431
Total current assets	1,432,329	1,407,496
Property and Equipment
Land	388,190	387,248
Buildings and improvements	3,593,055	3,366,146
Equipment	1,496,707	1,344,643
Property under capital lease	27,636	27,836
Property Equipment Gross	5,505,588	5,125,873
Accumulated depreciation	(2,249,733)	(1,986,110)
Property and equipment excluding construction in progress net	3,255,855	3,139,763
Construction-in-progress	186,314	242,472
Property Equipment, net	3,442,169	3,382,235
Other assets:
Goodwill	3,049,016	3,036,765
Deferred charges	57,881	75,888
Other	330,328	298,459
Other assets	3,437,225	3,411,112
Total assets	8,311,723	8,200,843
Current liabilities:
Current maturities of long-term debt	99,312	2,589
Accounts payable	276,911	247,033
Liabilities of facilities held for sale	0	850
Accrued liabilities
Compensation and related benefits	278,206	259,646
Interest	9,577	10,774
Taxes other than income	59,473	49,829
Other	329,282	322,275
Current federal and state income taxes	7,127	1,062
Total current liabilities	1,059,888	894,058
Other noncurrent liabilities	284,589	395,355
Long-term debt	3,209,762	3,727,431
Deferred income taxes	239,148	183,747
Commitments and contingencies (Note 8)
Redeemable noncontrolling interest	218,107	234,303
Equity:
Cumulative dividends	(225,531)	(205,910)
Retained earnings	3,499,337	2,962,433
Accumulated other comprehensive loss	(24,810)	(44,154)
Universal Health Services, Inc. common stockholders' equity	3,249,979	2,713,345
Noncontrolling interest	50,250	52,604
Total Equity	3,300,229	2,765,949
Liabilities and Equity, Total	8,311,723	8,200,843
Class A
Equity:
Common Stock	66	66
Class B
Equity:
Common Stock	910	903
Class C
Equity:
Common Stock	7	7
Class D
Equity:
Common Stock	$ 0	$ 0

Consolidated Balance Sheets (Parenthetical) (USD $)	Dec. 31, 2013	Dec. 31, 2012
Class A
Common Stock, par value	$ 0.01	$ 0.01
Common Stock, shares authorized	12,000,000	12,000,000
Common Stock, shares issued	6,595,708	6,625,708
Common Stock, shares outstanding	6,595,708	6,625,708
Class B
Common Stock, par value	$ 0.01	$ 0.01
Common Stock, shares authorized	150,000,000	150,000,000
Common Stock, shares issued	91,021,377	90,269,397
Common Stock, shares outstanding	91,021,377	90,269,397
Class C
Common Stock, par value	$ 0.01	$ 0.01
Common Stock, shares authorized	1,200,000	1,200,000
Common Stock, shares issued	664,000	664,000
Common Stock, shares outstanding	664,000	664,000
Class D
Common Stock, par value	$ 0.01	$ 0.01
Common Stock, shares authorized	5,000,000	5,000,000
Common Stock, shares issued	29,999	31,948
Common Stock, shares outstanding	29,999	31,948

Consolidated Statements of Changes in Equity (USD $) In Thousands, unless otherwise specified	Total	Redeemable Interest	Cumulative Dividends	UHS Common Stockholders' Equity	Class A Common	Class B Common	Class C Common	Class D Common	Capital in Excess of Par Value	Retained Earnings	Accumulated Other Comprehensive Income (Loss)	Noncontrolling Interest
Balance at Dec. 31, 2010		$ 211,761
Balance at Dec. 31, 2010	2,023,771		(128,049)	1,978,772	67	897	7	0	0	2,125,989	(20,139)	44,999
Common Stock
Issued/(converted) including tax benefits from exercise of stock options	12,633			12,633	(1)	12				12,622
Repurchased	(60,482)			(60,482)		(16)				(60,466)
Restricted share-based compensation expense	1,957			1,957						1,957
Dividends paid	(19,466)		(19,466)	(19,466)
Stock option expense	15,807			15,807						15,807
Distributions to noncontrolling interests	(7,416)	(31,016)										(7,416)
Comprehensive income:
Net income	411,350			398,167						398,167		13,183
Net income		37,521
Amortization of terminated hedge (net of income tax effect of $120 in 2013, $120 in 2012 and $120 in 2011)	(216)			(216)							(216)
Unrealized derivative gains and losses on cash flow hedges (net of income tax effect of $6390 in 2013, $2,528 in 2012 and $14,363 in 2011)	(23,114)			(23,114)							(23,114)
Minimum pension liability (net of income tax effect of $5670 in 2013, $1,898 in 2012 and $4,691 in 2011)	(7,706)			(7,706)							(7,706)
Subtotal-comprehensive income	380,314			367,131						398,167	(31,036)	13,183
Subtotal-comprehensive income		37,521
Balance at Dec. 31, 2011		218,266
Balance at Dec. 31, 2011	2,347,118		(147,515)	2,296,352	66	893	7	0	0	2,494,076	(51,175)	50,766
Common Stock
Issued/(converted) including tax benefits from exercise of stock options	21,684			21,684		14				21,670
Repurchased	(19,154)			(19,154)		(4)				(19,150)
Restricted share-based compensation expense	2,308			2,308						2,308
Dividends paid	(58,395)		(58,395)	(58,395)
Stock option expense	20,083			20,083						20,083
Distributions to noncontrolling interests	(7,933)	(18,961)										(7,933)
Sale of minority ownership interests in majority owned businesses	(832)											(832)
Comprehensive income:
Net income	454,049			443,446						443,446		10,603
Net income		34,998
Amortization of terminated hedge (net of income tax effect of $120 in 2013, $120 in 2012 and $120 in 2011)	(216)			(216)							(216)
Unrealized derivative gains and losses on cash flow hedges (net of income tax effect of $6390 in 2013, $2,528 in 2012 and $14,363 in 2011)	4,149			4,149							4,149
Minimum pension liability (net of income tax effect of $5670 in 2013, $1,898 in 2012 and $4,691 in 2011)	3,088			3,088							3,088
Subtotal-comprehensive income	461,070			450,467						443,446	7,021	10,603
Subtotal-comprehensive income		34,998
Balance at Dec. 31, 2012	234,303	234,303
Balance at Dec. 31, 2012	2,765,949		(205,910)	2,713,345	66	903	7	0	0	2,962,433	(44,154)	52,604
Common Stock
Issued/(converted) including tax benefits from exercise of stock options	26,880			26,880		11				26,869
Repurchased	(27,201)			(27,201)		(4)				(27,197)
Restricted share-based compensation expense	664			664						664
Dividends paid	(19,621)		(19,621)	(19,621)
Stock option expense	25,835			25,835						25,835
Distributions to noncontrolling interests	(13,039)	(48,290)										(13,039)
Other	(511)											(511)
Comprehensive income:
Net income	521,929			510,733						510,733		11,196
Net income		32,094
Amortization of terminated hedge (net of income tax effect of $120 in 2013, $120 in 2012 and $120 in 2011)	(216)			(216)							(216)
Unrealized derivative gains and losses on cash flow hedges (net of income tax effect of $6390 in 2013, $2,528 in 2012 and $14,363 in 2011)	10,573			10,573							10,573
Minimum pension liability (net of income tax effect of $5670 in 2013, $1,898 in 2012 and $4,691 in 2011)	8,987			8,987							8,987
Subtotal-comprehensive income	541,273			530,077						510,733	19,344	11,196
Subtotal-comprehensive income		32,094
Balance at Dec. 31, 2013	218,107	218,107
Balance at Dec. 31, 2013	$ 3,300,229		$ (225,531)	$ 3,249,979	$ 66	$ 910	$ 7	$ 0	$ 0	$ 3,499,337	$ (24,810)	$ 50,250

Consolidated Statements of Changes in Equity (Parenthetical) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Amortization of terminated hedge, income tax effect	$ 120	$ 120	$ 120
Unrealized derivative gains and losses on cash flow hedges, income tax effect	6,390	6,390	14,363
Minimum pension liability, income tax effect	$ 5,670	$ 1,898	$ 4,691

Consolidated Statements of Cash Flows (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Cash Flows from Operating Activities:
Net income	$ 554,023	$ 489,047	$ 448,870
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization	337,356	308,690	295,861
Gains on sales of assets and businesses, net of losses	(3,114)	(27,085)	(452)
Stock based compensation expense	27,783	22,518	18,225
Costs related to extinguishment of debt	0	29,170	0
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable	(49,708)	(71,068)	(134,838)
Accrued interest	(1,197)	152	(3,577)
Accrued and deferred income taxes	34,861	(5,666)	78,224
Other working capital accounts	26,234	28,554	(28,382)
Other assets and deferred charges	8,984	30,976	37,160
Other	23,485	6,367	(1,387)
Accrued insurance expense, net of commercial premiums paid	(3,821)	62,660	83,612
Payments made in settlement of self-insurance claims	(70,645)	(75,084)	(82,633)
Net cash provided by operating activities	884,241	799,231	710,683
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(358,493)	(363,192)	(285,682)
Acquisition of property and businesses	(12,636)	(527,847)	(29,466)
Proceeds received from sales of assets and businesses	37,482	149,311	67,592
Costs incurred for purchase and implementation of electronic health records application	(49,811)	(54,362)	(38,249)
Return of deposit on terminated purchase agreement	0	6,500	0
Net cash provided by (used in) investing activities	(383,458)	(789,590)	(285,805)
Cash Flows from Financing Activities:
Reduction of long-term debt	(440,224)	(849,647)	(381,517)
Additional borrowings	15,761	913,500	98,100
Financing costs	(231)	(8,283)	(23,608)
Repurchase of common shares	(27,201)	(19,154)	(60,482)
Dividends paid	(19,621)	(58,395)	(19,466)
Issuance of common stock	5,708	5,435	4,779
Excess income tax benefits related to stock based compensation	20,121	16,040	7,568
Profit distributions to noncontrolling interests	(61,329)	(26,895)	(38,497)
Net cash (used in) provided by financing activities	(507,016)	(27,399)	(413,123)
Increase (decrease) in cash and cash equivalents	(6,233)	(17,758)	11,755
Cash and cash equivalents, beginning of period	23,471	41,229	29,474
Cash and cash equivalents, end of period	17,238	23,471	41,229
Supplemental Disclosures of Cash Flow Information:
Interest paid	131,259	157,415	176,328
Income taxes paid, net of refunds	$ 259,896	$ 264,824	$ 163,029

Business and Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2013

Business and Summary of Significant Accounting Policies

1) BUSINESS AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Services provided by our hospitals, all of which are operated by subsidiaries of ours include general and specialty surgery, internal medicine, obstetrics, emergency room care, radiology, oncology, diagnostic care, coronary care, pediatric services, pharmacy services and/or behavioral health services. We, through our subsidiaries, provide capital resources as well as a variety of management services to our facilities, including central purchasing, information services, finance and control systems, facilities planning, physician recruitment services, administrative personnel management, marketing and public relations.

The more significant accounting policies follow:

A) Principles of Consolidation: The consolidated financial statements include the accounts of our majority-owned subsidiaries and partnerships controlled by us or our subsidiaries as the managing general partner. All significant intercompany accounts and transactions have been eliminated.

B) Revenue Recognition: We record revenues and related receivables for health care services at the time the services are provided. Medicare and Medicaid revenues represented 38% of our net patient revenues during 2013, 39% during 2012 and 41% during 2011. Revenues from managed care entities, including health maintenance organizations and managed Medicare and Medicaid programs accounted for 49% of our net patient revenues during each of 2013 and 2012 and 47% during 2011.

We report net patient service revenue at the estimated net realizable amounts from patients and third-party payors and others for services rendered. We have agreements with third-party payors that provide for payments to us at amounts different from our established rates. Payment arrangements include prospectively determined rates per discharge, reimbursed costs, discounted charges and per diem payments. Estimates of contractual allowances under managed care plans are based upon the payment terms specified in the related contractual agreements. We closely monitor our historical collection rates, as well as changes in applicable laws, rules and regulations and contract terms, to assure that provisions are made using the most accurate information available. However, due to the complexities involved in these estimations, actual payments from payors may be different from the amounts we estimate and record.

We estimate our Medicare and Medicaid revenues using the latest available financial information, patient utilization data, government provided data and in accordance with applicable Medicare and Medicaid payment rules and regulations. The laws and regulations governing the Medicare and Medicaid programs are extremely complex and subject to interpretation and as a result, there is at least a reasonable possibility that recorded estimates will change by material amounts in the near term. Certain types of payments by the Medicare program and state Medicaid programs (e.g. Medicare Disproportionate Share Hospital, Medicare Allowable Bad Debts and Inpatient Psychiatric Services) are subject to retroactive adjustment in future periods as a result of administrative review and audit and our estimates may vary from the final settlements. Such amounts are included in accounts receivable, net, on our Consolidated Balance Sheets. The funding of both federal Medicare and state Medicaid programs are subject to legislative and regulatory changes. As such, we cannot provide any assurance that future legislation and regulations, if enacted, will not have a material impact on our future Medicare and Medicaid reimbursements. Adjustments related to the final settlement of these retrospectively determined amounts did not materially impact our results in 2013, 2012 or 2011.

We provide care to patients who meet certain financial or economic criteria without charge or at amounts substantially less than our established rates. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in net revenues or in accounts receivable, net. See additional disclosure below in Charity Care and Uninsured Discounts for our estimated uncompensated care provided and estimated cost of providing uncompensated care.

C) Provision for Doubtful Accounts: Collection of receivables from third-party payers and patients is our primary source of cash and is critical to our operating performance. Our primary collection risks relate to uninsured patients and the portion of the bill which is the patient’s responsibility, primarily co-payments and deductibles. We estimate our provisions for doubtful accounts based on general factors such as payer mix, the agings of the receivables and historical collection experience. We routinely review accounts receivable balances in conjunction with these factors and other economic conditions which might ultimately affect the collectability of the patient accounts and make adjustments to our allowances as warranted. At our acute care hospitals, third party liability accounts are pursued until all payment and adjustments are posted to the patient account. For those accounts with a patient balance after third party liability is finalized or accounts for uninsured patients, the patient receives statements and collection letters. Patients that express an inability to pay are reviewed for potential sources of financial assistance including our charity care policy. If the patient is deemed unwilling to pay, the account is written-off as bad debt and transferred to an outside collection agency for additional collection effort.

Uninsured patients that do not qualify as charity patients are extended an uninsured discount of a minimum of 30% of total charges. Our hospitals establish a partial reserve for self-pay accounts in the allowance for doubtful accounts for both unbilled balances and those that have been billed and are under 90 days old. All self-pay accounts are fully reserved at 90 days from the date of discharge. Third party liability accounts are fully reserved in the allowance for doubtful accounts when the balance ages past 180 days from the date of discharge. Potential charity accounts are fully reserved when it is determined the patient may be unable to pay.

Our accounts receivable as of December 31, 2013, 2012 and 2011 includes amounts due from Illinois of approximately $49 million, $70 million and $54 million, respectively. Collection of the outstanding receivables continues to be delayed due to state budgetary and funding pressures. Approximately $28 million as of December 31, 2013, $51 million as of December 31, 2012 and $41 million as of December 31, 2011, of the receivables due from Illinois were outstanding in excess of 60 days, as of each respective date. In addition, our accounts receivable as of December 31, 2013 includes approximately $46 million due from Texas in connection with Medicaid supplemental payment programs the majority of which we expect to collect during the second quarter of 2014. Although the accounts receivable due from Illinois and Texas could remain outstanding for the foreseeable future, since we expect to eventually collect all amounts due to us (we have received $27 million of cash remittances from Illinois in January, 2014), 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 and/or Texas. Failure to ultimately collect all outstanding amounts due from these states would have an adverse impact on our future consolidated results of operations and cash flows.

On a consolidated basis, we monitor our total self-pay receivables to ensure that the total allowance for doubtful accounts provides adequate coverage based on historical collection experience. Our accounts receivable are recorded net of allowance for doubtful accounts of $395 million and $311 million at December 31, 2013 and 2012, respectively.

D) Concentration of Revenues: Our five majority owned acute care hospitals in the Las Vegas, Nevada market contributed, on a combined basis, 14% of our consolidated net revenues in each of 2013 and 2012 and 15% in 2011. On a combined basis, our facilities in the McAllen/Edinburg, Texas market (consisting of three acute care facilities, a children’s hospital and a behavioral health facility) contributed 4% of our consolidated net revenues in each of 2013 and 2012 and 5% in 2011.

E) Charity Care and Uninsured Discounts: A significant portion of the patients treated throughout our portfolio of acute care hospitals are uninsured patients which, in part, has resulted from an increase in the number of patients who are employed but do not have health insurance or who have policies with relatively high deductibles. Patients treated at our hospitals for non-elective services, who have gross income less than 400% of the federal poverty guidelines, are deemed eligible for charity care. The federal poverty guidelines are established by the federal government and are based on income and family size. Because we do not pursue collection of amounts that qualify as charity care, they are not reported in our net revenues or in our accounts receivable, net. We also provide discounts to uninsured patients (included in “uninsured discounts” amounts below) who do not qualify for Medicaid or charity care. Because we do not pursue collection of amounts classified as uninsured discounts, they are not reported in our net revenues or in our accounts receivable, net. In implementing the discount policy, we first attempt to qualify uninsured patients for governmental programs, charity care or any other discount program. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.

Uncompensated care:

The following table shows the amounts recorded at our acute care hospitals for charity care and uninsured discounts, based on charges at established rates, for the years ended December 31, 2013, 2012 and 2011:


	(dollar amounts in thousands)
	2013					2012					2011
	Amount		%			Amount		%			Amount		%
Charity care	$	593,474		59	%	$	778,268		74	%	$	804,301		84	%
Uninsured discounts		405,296		41	%		267,304		26	%		151,447		16	%

Total uncompensated care	$	998,770		100	%	$	1,045,572		100	%	$	955,748		100	%

In addition, the provision for doubtful accounts at our acute care hospitals were approximately $1.02 billion during 2013, $635 million during 2012 and $519 million during 2011.

The estimated cost of providing uncompensated care:

The estimated cost of providing uncompensated care, as reflected below, were based on a calculation which multiplied the percentage of operating expenses for our acute care hospitals to gross charges for those hospitals by the above-mentioned total uncompensated care amounts. The percentage of cost to gross charges is calculated based on the total operating expenses for our acute care facilities divided by gross patient service revenue for those facilities. An increase in the level of uninsured patients to our facilities and the resulting adverse trends in the provision for doubtful accounts and uncompensated care provided could have a material unfavorable impact on our future operating results.


	(amounts in thousands)
	2013		2012		2011
Estimated cost of providing charity care	$	95,675	$	131,890	$	145,350
Estimated cost of providing uninsured discounts related care		65,338		45,299		27,363

Estimated cost of providing uncompensated care	$	161,013	$	177,189	$	172,713

F) Accounting for Medicare and Medicaid Electronic Health Records Incentive Payments: In July 2010, the Department of Health and Human Services published final regulations implementing the health information technology provisions of the American Recovery and Reinvestment Act. The regulation defines the “meaningful use” of Electronic Health Records (“EHR”) and established the requirements for the Medicare and Medicaid EHR payment incentive programs. The implementation period for these new Medicare and Medicaid incentive payments started in federal fiscal year 2011 and can end as late as 2016 for Medicare and 2021 for the state Medicaid programs. We recognize income related to Medicare and Medicaid incentive payments using a gain contingency model that is based upon when our eligible hospitals have demonstrated “meaningful use” of certified EHR technology for the applicable period and the cost report information for the full cost report year that will determine the final calculation of the incentive payment is available.

Medicare EHR incentive payments: Federal regulations require that Medicare EHR incentive payments be computed based on the Medicare cost report that begins in the federal fiscal period in which a hospital meets the applicable “meaningful use” requirements. Since the annual Medicare cost report periods for each of our acute care hospitals ends on December 31^st, we will recognize Medicare EHR incentive income for each hospital during the fourth quarter of the year in which the facility meets the “meaningful use” criteria and during the fourth quarter of each applicable subsequent year.

Medicaid EHR incentive payments: Medicaid EHR incentive payments are determined based upon prior period cost report information available at the time our hospitals met the “meaningful use” criteria. Therefore, the majority of the Medicaid EHR incentive income recognition occurred in the period in which the applicable hospitals were deemed to have met initial “meaningful use” criteria. Upon meeting subsequent fiscal year “meaningful use” criteria, our hospitals may become entitled to additional Medicaid EHR incentive payments which will be recognized as incentive income in future periods. Medicaid EHR incentive payments received prior to our hospitals meeting the “meaningful use” criteria were included in other current liabilities (as deferred EHR incentive income) in our consolidated balance sheet.

G) Cash and Cash Equivalents: We consider all highly liquid investments purchased with maturities of three months or less to be cash equivalents.

H) Property and Equipment: Property and equipment are stated at cost. Expenditures for renewals and improvements are charged to the property accounts. Replacements, maintenance and repairs which do not improve or extend the life of the respective asset are expensed as incurred. We remove the cost and the related accumulated depreciation from the accounts for assets sold or retired and the resulting gains or losses are included in the results of operations. Construction-in-progress includes both construction projects and equipment not yet placed into service.

We capitalize interest expense on major construction projects while in progress. We capitalized interest on major construction projects and the development and implementation of electronic health records applications amounting to $4.9 million during 2013, $5.7 million during 2012 and $400,000 during 2011.

Depreciation is provided on the straight-line method over the estimated useful lives of buildings and improvements (twenty to forty years) and equipment (three to fifteen years). Depreciation expense (excluding discontinued operations) was $285.6 million during 2013, $270.5 million during 2012 and $262.1 million during 2011.

I) Long-Lived Assets: We review our long-lived assets, including intangible assets, for impairment whenever events or circumstances indicate that the carrying value of these assets may not be recoverable. The assessment of possible impairment is based on our ability to recover the carrying value of our asset based on our estimate of its undiscounted future cash flow. If the analysis indicates that the carrying value is not recoverable from future cash flows, the asset is written down to its estimated fair value and an impairment loss is recognized. Fair values are determined based on estimated future cash flows using appropriate discount rates.

J) Goodwill and Intangible Assets: Goodwill and indefinite-lived intangible assets are reviewed for impairment at the reporting unit level on an annual basis or sooner if the indicators of impairment arise. Our judgments regarding the existence of impairment indicators are based on market conditions and operational performance of each reporting unit. We have designated September 1^st as our annual impairment assessment date and performed an impairment assessment as of September 1, 2013 which indicated no impairment of goodwill or indefinite-lived intangible assets. There were also no impairments during 2012 or 2011. Future changes in the estimates used to conduct the impairment review, including profitability and market value projections, could indicate impairment in future periods potentially resulting in a write-off of a portion or all of our goodwill or indefinite-lived intangible assets.

Changes in the carrying amount of goodwill for the two years ended December 31, 2013 were as follows (in thousands):


	Acute Care Services			Behavioral Health Services			Total Consolidated
Balance, January 1, 2012	$	389,484		$	2,238,118		$	2,627,602
Goodwill acquired during the period		11,110			434,551			445,661
Goodwill divested during the period		(17,450	)		(1,902	)		(19,352	)
Adjustments to goodwill (a)		(448	)		(16,698	)		(17,146	)

Balance, January 1, 2013		382,696			2,654,069			3,036,765
Adjustments to goodwill (b)		315			11,936			12,251

Balance, December 31, 2013	$	383,011		$	2,666,005		$	3,049,016

(a)

The reduction to the Behavioral Health Services’ goodwill consists primarily of a reclassification to “assets of facilities held for sale” and represents the goodwill attributable to Peak Behavioral Health Services which we agreed to divest pursuant to our agreement with the Federal Trade Commission in connection with our acquisition of Ascend Health Corporation in October, 2012. Adjustments to prior year purchase price allocations for Acute Care and Behavioral Health Services are also included.

(b)	The increase in the Behavioral Health Services’ goodwill consists primarily of an amount that was reclassified from other assets.

K) Other Assets: Other assets consist primarily of amounts related to: (i) intangible assets acquired in connection with our acquisition of Psychiatric Solutions, Inc. (“PSI”) in November, 2010 and Ascend Health Corporation in October, 2012, consisting of Medicare licenses, certificates of need and contracts to manage the operations of behavioral health services owned by third-parties (PSI only); (ii) prepaid fees for various software and other applications used by our hospitals; (iii) costs incurred in connection with the purchase and implementation of an electronic health records application for each of our acute care facilities; (iv) deposits; (v) investments in various businesses, including Universal Health Realty Income Trust; (vi) the invested assets related to a deferred compensation plan that is held by an independent trustee in a rabbi-trust and that has a related payable included in other noncurrent liabilities; (vii) the estimated future payments related to physician-related contractual commitments, as discussed below, and; (viii) other miscellaneous assets. As of December 31, 2013 and 2012, other intangible assets, net of accumulated amortization, were approximately $97 million and $99 million, respectively.

L) Physician Guarantees and Commitments: As of December 31, 2013 and 2012, our accrued liabilities-other, and our other assets included $3 million, as of each respective date, of estimated future payments related to physician-related contractual commitments. The $3 million of potential future financial obligations outstanding as of December 31, 2013 are potential 2014 obligations.

M) Self-Insured Risks: We provide for self-insured risks, primarily general and professional liability claims and workers’ compensation claims. 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, estimate of incurred but not reported claims based on historical experience, and estimates of amounts recoverable under our commercial insurance policies. All relevant information, including our own historical experience is used in estimating the expected amount of claims. 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. Our estimated self-insured reserves are reviewed and changed, if necessary, at each reporting date and changes are recognized currently as additional expense or as a reduction of expense. See Note 8 for discussion of adjustments to our prior year reserves for claims related to our self-insured general and professional liability and workers’ compensation liability.

In addition, we also maintain self-insured employee benefits programs for employee healthcare and dental claims. The ultimate costs related to these programs include expenses for claims incurred and paid in addition to an accrual for the estimated expenses incurred in connection with claims incurred but not yet reported.

N) Income Taxes: Deferred tax assets and liabilities are recognized for the amount of taxes payable or deductible in future years as a result of differences between the tax bases of assets and liabilities and their reported amounts in the financial statements. We believe that future income will enable us to realize our deferred tax assets net of recorded valuation allowances relating to state net operating loss carry-forwards.

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.

See Note 6—Income Taxes, for additional disclosure.

O) Other Noncurrent Liabilities: Other noncurrent liabilities include the long-term portion of our professional and general liability, workers’ compensation reserves, pension and deferred compensation liabilities, liability incurred in connection with split-dollar life insurance agreements on the lives of our chief executive officer and his wife and interest rate swap liabilities.

P) Redeemable Noncontrolling Interests and Noncontrolling Interest: Outside owners hold noncontrolling, minority ownership interests of: (i) approximately 28% in our five acute care facilities located in Las Vegas, Nevada; (ii) 20% in an acute care facility located in Washington, D.C.; (iii) approximately 11% in an acute care facility located in Laredo, Texas, and; (iv) 20% in a behavioral health care facility located in Philadelphia, Pennsylvania. The redeemable noncontrolling interest balances of $218 million and $234 million as of December 31, 2013 and 2012, respectively, and the noncontrolling interest balances of $50 million and $53 million as of December 31, 2013 and 2012, respectively, consist primarily of the third-party ownership interests in these hospitals.

In connection with the five acute care facilities located in Las Vegas, Nevada, the minority ownership interests of which are reflected as redeemable noncontrolling interests on our Consolidated Balance Sheet, the outside owners have certain “put rights”, that are currently exercisable, that if exercised, require us to purchase the minority member’s interests at fair market value. The put rights are exercisable upon the occurrence of: (i) certain specified financial conditions falling below established thresholds; (ii) breach of the management contract by the managing member (a subsidiary of ours), or; (iii) if the minority member’s ownership percentage is reduced to less than certain thresholds. In connection with the behavioral health care facility located in Philadelphia, Pennsylvania, the minority ownership interest of which is also reflected as redeemable noncontrolling interests on our Consolidated Balance Sheet, the outside owner has a “put option” to put its 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. As of December 31, 2013, we believe the fair market value of the minority ownership interests in these facilities, pursuant to the terms of the put options, approximates the book value of the redeemable noncontrolling interests.

Q) Comprehensive Income and Accumulated Other Comprehensive Income: Comprehensive income or loss is comprised of net income, changes in unrealized gains or losses on derivative financial instruments and a pension liability.

The accumulated other comprehensive income (“AOCI”) component of stockholders’ equity includes: net unrealized gains and losses on effective cash flow hedges; and the net minimum pension liability of a non-contributory defined benefit pension plan which covers employees at one of our subsidiaries. See Note 10, “Pension Plan” for additional disclosure regarding the defined benefit pension plan.

The amounts recognized in AOCI for the two years ended December 31, 2013 were as follows (in thousands):


	Net Unrealized Gains (Losses) on Effective Cash Flow Hedges			Minimum Pension Liability			Total AOCI
Balance, January 1, 2012, net of income tax	$	(28,460	)	$	(22,715	)	$	(51,175	)
2012 activity:
Pre-tax amount		6,341			4,986			11,327
Income tax effect		(2,408	)		(1,898	)		(4,306	)

Change, net of income tax		3,933			3,088			7,021

Balance, January 1, 2013, net of income tax		(24,527	)		(19,627	)		(44,154	)
2013 activity:
Pre-tax amount		16,627			14,657			31,284
Income tax effect		(6,270	)		(5,670	)		(11,940	)

Change, net of income tax		10,357			8,987			19,344

Balance, December 31, 2013, net of income tax	$	(14,170	)	$	(10,640	)	$	(24,810	)

R) Accounting for Derivative Financial Investments and Hedging Activities: We manage our ratio of fixed to 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.

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.

Derivative instruments designated in a hedge relationship to mitigate exposure to changes in the fair value of an asset, liability, or firm commitment attributable to a particular risk, such as interest rate risk, are considered fair value hedges. Fair value hedges are accounted for by recording the changes in the fair value of both the derivative instrument and the hedged item 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.

S) Stock-Based Compensation: At December 31, 2013, we have a number of stock-based employee compensation plans. Pursuant to the FASB’s guidance, we expense the grant-date fair value of stock options and other equity-based compensation pursuant to the straight-line method over the stated vesting period of the award using the Black-Scholes option-pricing model.

The expense associated with share-based compensation arrangements is a non-cash charge. In the Consolidated Statements of Cash Flows, share-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities. The applicable FASB guidance requires that cash flows resulting from tax deductions in excess of compensation cost recognized be classified as financing cash flows.

T) Earnings Per Share: Basic earnings per share are based on the weighted average number of common shares outstanding during the year. Diluted earnings per share are based on the weighted average number of common shares outstanding during the year adjusted to give effect to common stock equivalents.

The following table sets forth the computation of basic and diluted earnings per share, for the periods indicated:


	Twelve Months Ended December 31,
	2013			2012			2011
Basic and diluted:
Net Income	$	554,023		$	489,047		$	448,870
Less: Net income attributable to noncontrolling interest		(43,290	)		(45,601	)		(50,703	)
Less: Net income attributable to unvested restricted share grants		(294	)		(497	)		(521	)

Net income attributable to UHS—basic and diluted	$	510,439		$	442,949		$	397,646

Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		98,033			96,821			97,199

Total basic earnings per share	$	5.21		$	4.57		$	4.09

Diluted earnings per share attributable to UHS:
Weighted average number of common shares		98,033			96,821			97,199
Net effect of dilutive stock options and grants based on the treasury stock method		1,328			890			1,338

Weighted average number of common shares and equivalents—diluted		99,361			97,711			98,537

Total diluted earnings per share	$	5.14		$	4.53		$	4.04

The “Net effect of dilutive stock options and grants based on the treasury stock method”, for all years presented above, excludes certain outstanding stock options applicable to each year since the effect would have been anti-dilutive. The excluded weighted-average stock options totaled 4,000 during 2013, 2.0 million during 2012, 1.4 million during 2011.

U) Fair Value of Financial Instruments: The fair values of our registered debt and investments are based on quoted market prices. The fair values of other long-term debt, including capital lease obligations, are estimated by discounting cash flows using period-end interest rates and market conditions for instruments with similar maturities and credit quality. The carrying amounts reported in the balance sheet for cash, accounts receivable, accounts payable, and short-term borrowings approximates their fair values due to the short-term nature of these instruments. Accordingly, these items have been excluded from the fair value disclosures included elsewhere in these notes to consolidated financial statements.

V) Use of Estimates: The preparation of financial statements in conformity with U.S. generally accepted accounting principles requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

W) Mergers and Acquisitions: The acquisition method of accounting for business combinations requires that the assets acquired and liabilities assumed be recorded at the date of acquisition at their respective fair values with limited exceptions. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Any excess of the purchase price (consideration transferred) over the estimated fair values of net assets acquired is recorded as goodwill. Transaction costs and costs to restructure the acquired company are expensed as incurred. The fair value of intangible assets, including Medicare Licenses, Certificates of Need, and certain contracts, is based on significant judgments made by our management, and accordingly, for significant items we typically obtain assistance from third party valuation specialists.

X) GPO Agreement/Minority Ownership Interest: During 2013, we entered into a new group purchasing organization agreement (“GPO”) and acquired a minority interest in the GPO for a nominal amount. In connection with the completion of an initial public offering of the stock of the GPO, during the fourth quarter of 2013, we received cash proceeds for the sale of a portion of our ownership interest, which were recorded as deferred income and included in liabilities on our consolidated balance sheet as of December 31, 2013. The deferred income will be recognized, on a pro rata basis, as a reduction to our supplies expense over the expected life of the GPO agreement. Also in connection with this GPO agreement and related minority interest ownership, we received shares of restricted stock in the GPO which vest ratably over a seven-year period, contingent upon our continued participation and minority ownership interest in the GPO. We will recognize the fair value of this restricted stock, as a reduction to our supplies expense, in our consolidated statements of income on a pro rata basis over the vesting period.

Y) Accounting Standards:

Reporting of Amounts Reclassified out of Other Comprehensive Income: In February 2013, the Financial Accounting Standards Board issued an Accounting Standards Update on reporting of amounts reclassified out of accumulated other comprehensive income. This guidance, which is effective for fiscal years beginning after December 15, 2012, requires companies to provide information about amounts reclassified out of accumulated other comprehensive income by component (the respective line items of the income statement). The adoption of this standard on January 1, 2013 had no impact on our financial position or overall results of operations.

Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities: During the first quarter of 2012, we adopted the Financial Accounting Standards Board’s Accounting Standards Update (“ASU”) No. 2011-07, “Health Care Entities (Topic 954): Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities,” which required certain health care entities to change the presentation in their statement of operations by reclassifying the provision for bad debts associated with patient service revenue from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts). As a result, the provision for doubtful accounts for our acute care and behavioral health care facilities is reflected as a deduction from net revenues in the accompanying consolidated statements of income for each of the years presented herein. The adoption of this standard had no impact on our financial position or overall results of operations.

Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward Exists: In July 2013, the Financial Accounting Standards Board issued guidance regarding the presentation of an unrecognized tax benefit when a net operating loss carryforward, a similar tax loss, or a tax credit carryforward exists. Under certain circumstances, unrecognized tax benefits should be presented in the financial statements as a reduction to a deferred tax asset for a net operating loss carryforward, a similar tax loss, or a tax credit carryforward. The guidance is a change in financial statement presentation only and has no material impact in the consolidated financial results. The guidance is effective beginning January 1, 2014 on either a prospective or retrospective basis.

Acquisitions and Divestitures

12 Months Ended

Dec. 31, 2013

Acquisitions and Divestitures

2) ACQUISITIONS AND DIVESTITURES

Year ended December 31, 2013:

2013 Acquisitions of Assets and Businesses:

During 2013, we spent an aggregate of $13 million for the purchase of real property located in Pennsylvania, Nevada and Arizona. The aggregate net purchase price of these properties was allocated to property and equipment on our consolidated balance sheet.

2013 Divestiture of Assets and Businesses:

During 2013, we received an aggregate of $37 million in connection with the divestiture of Peak Behavioral Health Services (sold during the second quarter of 2013) and certain other assets and real property including three previously closed behavioral health care facilities. As discussed below in Discontinued Operations, we agreed to sell Peak Behavioral Health Services as part of our agreement with the Federal Trade Commission (“FTC”) in connection with our acquisition of Ascend Health Corporation (“Ascend”) in October of 2012. The aggregate pre-tax gain on these divestitures was approximately $3 million and in included in our 2013 consolidated results of operations.

Year ended December 31, 2012:

2012 Acquisitions of Assets and Businesses:

During 2012, we spent $528 million to acquire the following assets and businesses:

•

spent $503 million to acquire 9 behavioral health care facilities from Ascend in October, 2012, and;

•

spent $25 million in connection with the acquisition of physician practices and various real property.

The aggregate net purchase price of the facilities was allocated to assets and liabilities based on their estimated fair values as follows:


	Amount (000s)
Working capital, net	$	21,000
Property & equipment		60,000
Goodwill		446,000
Other assets		9,000
Income tax assets, net of deferred tax liabilities		(1,000	)
Other liabilities		(7,000	)

Cash paid in 2012 for acquisitions	$	528,000

Goodwill of the facilities acquired is computed, pursuant to the residual method, by deducting the fair value of the acquired assets and liabilities from the total purchase price. The factors that contribute to the recognition of goodwill, which may also influence the purchase price, include the following for each of the acquired facilities: (i) the historical cash flows and income levels; (ii) the reputations in their respective markets; (iii) the nature of the respective operations, and; (iv) the future cash flows and income growth projections.

Assuming the acquisition of Ascend occurred on January 1, 2011, our 2011 unaudited pro forma net revenues would have been approximately $6.90 billion and our unaudited pro forma net income attributable to UHS and unaudited pro forma net income attributable to UHS per diluted share would have been $401 million and $4.06 per diluted share, respectively. The 2011 unaudited pro forma net income attributable to UHS and unaudited pro forma net income attributable to UHS per diluted share include the after-tax impact of the transaction costs incurred by us in connection with the acquisition of Ascend amounting to $5 million or $.06 per diluted share. Our 2012 unaudited pro forma net revenues would have been approximately $7.11 billion and our unaudited pro forma net income attributable to UHS and unaudited pro forma net income attributable to UHS per diluted share would have been $464 million and $4.74 per diluted share, respectively.

During the period of October 10, 2012 through December 31, 2012, the facilities acquired from Ascend generated $42 million of net revenues which are included in our consolidated net revenues for the year ended December 31, 2012. The aggregate effect of the earnings generated by these facilities since the date of acquisition, less the cost on the borrowings utilized to finance the acquisition, and less the above-mentioned transaction costs, was not material to our 2012 net income attributable to UHS and net income attributable to UHS per diluted share.

2012 Divestiture of Assets and Businesses:

During 2012, we received $149 million from the divestiture of assets and businesses, including the following:

•

received $93 million for the sale of Auburn Regional Medical Center (“Auburn”), a 159-bed acute care hospital located in Auburn, Washington (sold in October of 2012);

•

received $50 million for the sale of the Hospital San Juan Capestrano, a 108-bed acute care hospital located in Rio Piedras, Puerto Rico (sold in January of 2012 pursuant to our below-mentioned agreement with the FTC in connection with our acquisition of PSI in November, 2010), and;

•

received an aggregate of $6 million for the sale of the real property of two non-operating behavioral health facilities and our majority ownership interest in an outpatient surgery center located in Puerto Rico.

Included in our 2012 consolidated results of operations was a $26 million pre-tax gain on the divestiture of Auburn. The divestiture of San Juan Capestrano (in January, 2012) did not have a material impact on our consolidated results of operations.

Year ended December 31, 2011:

2011 Acquisitions of Assets and Businesses:

During 2011, we spent $29 million on the acquisition of businesses and real property, including the following:

•

the acquisition of administrative office buildings located in Pennsylvania, Tennessee and a multi-tenant office building located in Washington D.C.;

•

a deposit in made connection with execution of a purchase agreement for an acute care hospital in Texas which has since been terminated and the deposit returned to us in 2012, and;

•

the acquisition of a cardiology practice in Texas.

The aggregate net cash expenditure related to the properties and/or businesses was allocated to assets and liabilities based on their estimated fair values as follows:


	Amount (000s)
Property, plant & equipment	$	35,000
Other assets/deposits		11,000
Debt		(17,000	)

Cash paid in 2011 for acquisitions and deposits	$	29,000

2011 Divestitures of Assets and Businesses:

During 2011, we received $68 million from the divestiture of assets and businesses, including the following:

•

the sale of three behavioral healthcare facilities (one located in Delaware and two located in Nevada) pursuant to the below-mentioned agreement with the FTC in connection with our acquisition of PSI;

•

sale of our majority ownership interest in a radiation oncology center located in Nevada, and;

•

the real property of a closed acute care hospital.

The aggregate pre-tax net gain on these divestitures did not have a material impact on our 2011 consolidated results of operations.

Discontinued Operations:

In connection with the receipt of antitrust clearance from the FTC in connection with our acquisition of Ascend in October of 2012, we agreed to certain conditions, including the divestiture of Peak Behavioral Health Services (“Peak”), a 104-bed behavioral health care facility located in Santa Teresa, New Mexico. The divestiture of Peak was completed during the second quarter of 2013 for total cash proceeds of approximately $24 million resulting in a pre-tax gain of approximately $3 million which is included in our 2013 consolidated financial statements.

In October of 2012, we completed the divestiture of Auburn, a 159-bed acute care hospital located in Auburn, Washington, for total cash proceeds of approximately $93 million. This divestiture resulted in a pre-tax gain of $26 million which was included in our 2012 consolidated financial statements.

In connection with the receipt of antitrust clearance from the FTC in connection with our acquisition of PSI in November, 2010, we agreed to divest three former PSI facilities as well as one of our legacy behavioral health facilities in Puerto Rico. Pursuant to the terms of our agreement with the FTC, we divested:

•

in July, 2011, the MeadowWood Behavioral Health System, a 58-bed facility located in New Castle, Delaware;

•

in December, 2011, the Montevista Hospital (101-bed) and Red Rock Hospital (21-bed), both of which are located in Las Vegas, Nevada, and;

•

in January, 2012, the Hospital San Juan Capestrano, a 108-bed facility located in Rio Piedras, Puerto Rico.

The operating results for Auburn, Peak and the three former PSI facilities located in Delaware and Nevada are reflected as discontinued operations during our period of ownership during each of the years presented herein. Since the aggregate income from discontinued operations before income tax expense for these facilities is not material to our consolidated financial statements, it is included as a reduction to other operating expenses. Assets and liabilities for Peak were reflected as “held for sale” on our Consolidated Balance Sheet as of December 31, 2012.

The following table shows the results of operations for Auburn and Peak and the former PSI facilities located in Delaware and Nevada, on a combined basis, which were reflected as discontinued operations during our period of ownership for each of the years presented herein (amounts in thousands):


	2013			2012			2011
Net revenues	$	7,813		$	95,226		$	159,218
Income (loss) from discontinued operations, before income taxes		932			(3,472	)		10,422
Gain on divestiture		3,080			26,419			442

Income from discontinued operations, before income tax expense		4,012			22,947			10,864
Income tax expense		(1,506	)		(8,688	)		(4,113	)

Income from discontinued operations, net of income taxes	$	2,506		$	14,259		$	6,751

Financial Instruments

12 Months Ended

Dec. 31, 2013

Financial Instruments

3) FINANCIAL INSTRUMENTS

Fair Value Hedges:

During 2013, 2012 and 2011, we had no fair value hedges outstanding.

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.

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 2013 and 2012 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. However, at December 31, 2013, each swap agreement entered into by us was in a net liability position which would require us to make the net settlement payments to the counterparties. We do not anticipate nonperformance by our counterparties. We do not hold or issue derivative financial instruments for trading purposes.

During 2011, we entered into a forward starting interest rate cap on a total notional amount of $450 million from December, 2011 to December, 2012 reducing to $400 million from December, 2012 to December, 2013 whereby we paid a premium of $740,000 in exchange for the counterparty agreeing to pay the difference between 7.00% and three-month LIBOR if the three-month LIBOR rate rises above 7.00% during the term of the cap. The three-month LIBOR never reached 7.00% during the term of the cap, which expired in December, 2013, and therefore no payment was made to us.

We also entered into six forward starting interest rate swaps in 2011 whereby we pay a fixed rate on a total notional amount of $425 million and receive three-month LIBOR. Three of these swaps with a total notional amount of $225 million became effective in March, 2011 and will mature in May, 2015. The average fixed rate payable on these swaps is 1.91%. The three remaining interest rate swaps with total notional amounts of $75 million, $25 million and $100 million became effective in December, 2011 and have corresponding fixed rates of 1.32%, 1.96% and 2.50%. The $75 million and $25 million interest rate swaps matured in December, 2012 and December, 2013, respectively, and the $100 million interest rate swap is scheduled to mature in December, 2014.

During 2010, we entered into four forward starting interest rate swaps whereby we pay a fixed rate on a total notional amount of $600 million and receive three-month LIBOR. Each of the four swaps became effective in December, 2011 and will mature in May, 2015. The average fixed rate payable on these swaps is 2.38%.

During the fourth quarter of 2007, we entered into two interest rate swaps whereby we paid a fixed rate on a total notional principal amount of $150 million and received three-month LIBOR. Each of the two interest rate swaps, which are now expired, had an initial notional principal amount of $75 million. The fixed rate payable on one of the interest rate swaps was 4.87% and it matured in October, 2011. The fixed rate payable on the other interest rate swap, on which the notional principal amount reduced to $50 million in October, 2010, was 4.76% and it matured in October, 2012.

We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based primarily on quotes from banks. 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. The fair value of our interest rate swaps was a liability of $24 million at December 31, 2013, of which $19 million is included in other current liabilities and $5 million is included in other noncurrent liabilities on the accompanying balance sheet. At December 31, 2012, the fair value of our interest rate swaps was a liability of $41 million, substantially all of which is included in other noncurrent liabilities on the accompanying balance sheet.

Long-Term Debt

12 Months Ended

Dec. 31, 2013

Long-Term Debt

4) LONG-TERM DEBT

A summary of long-term debt follows:


	December 31,
	2013			2012
	(amounts in thousands)
Long-term debt:
Notes payable and Mortgages payable (including obligations under capitalized leases of $6,633 in 2013 and $8,267 in 2012) and term loans with varying maturities through 2037; weighted average interest rates of 5.9% in each of 2013 and 2012 (see Note 7 regarding capitalized leases)	$	37,553		$	47,216
Revolving credit and on-demand credit facility		25,500			163,500
Term Loan A, net of unamortized discount of $3,340 in 2013 and $4,612 in 2012		935,308			983,438
Term Loan B, net of unamortized discount of $6,473 in 2013 and $8,724 in 2012		543,527			737,176
Term Loan A2		871,875			894,375
Revenue bonds, interest at floating rates of 0.1% at December 31, 2013 and 0.2% at December 31, 2012, with varying maturities through 2015		5,300			5,300
Accounts receivable securitization program		240,000			249,000
7.125% Senior Secured Notes due 2016, including unamortized net premium of $11 in 2013 and $15 in 2012		400,011			400,015
7.00% Senior Unsecured Notes due 2018		250,000			250,000

		3,309,074			3,730,020
Less-Amounts due within one year		(99,312	)		(2,589	)

	$	3,209,762		$	3,727,431

In May, 2013, we entered into a third amendment (the “Third Amendment”) to the credit agreement, dated as of November 15, 2010 (as amended from time to time, the “Credit Agreement”), which became effective that day, among UHS, the several banks and other financial institutions from time to time parties thereto, JPMorgan Chase Bank, N.A., as administrative agent and the other agents party thereto. The Third Amendment provides for a reduction in the interest rates payable in connection with certain borrowings under the Credit Agreement. Upon the effectiveness of the Third Amendment, UHS replaced its existing $745.9 million senior secured Tranche B term loan with a new senior secured Tranche B-1 term loan in the same amount on substantially the same terms as the Tranche B term loan, other than lower interest rates. Borrowings under the Tranche B-1 term loan bear interest at a rate per annum equal to, at our election, one, two, three or six month LIBOR, plus an applicable margin of 2.25% or ABR plus an applicable margin of 1.25%. The minimum LIBOR and ABR rates for the Tranche B term loan of 1.0% and 2.0%, respectively, were eliminated.

In September, 2012, we entered into a second amendment (“Second Amendment”) to our Credit Agreement which provided for: (i) a new $900 million Term Loan-A (“Term Loan A2”) at the same interest rates as our existing Term Loan A and a final maturity date of August 15, 2016; (ii) the extension of the maturity date on a substantial portion of our $800 million revolving credit facility commitment with $777 million of the commitment extended to mature on August 15, 2016 and the remaining $23 million commitment scheduled to mature on November 15, 2015 (there were no borrowings outstanding pursuant to our revolving credit facility as of December 31, 2013), and; (iii) the extension of the maturity date on a substantial portion of our Term Loan-A borrowings which, based upon the outstanding Term Loan-A borrowings as of December 31, 2013, $892 million is scheduled to mature on August 15, 2016 and the remaining $43 million is scheduled to mature on November 15, 2015. The Second Amendment also provides for increased flexibility for refinancing and certain other modifications but substantially all other terms of the Credit Agreement remain unchanged.

In September, 2012, we used $700 million of the proceeds from the new Term Loan A2 facility to extinguish a portion of our higher priced, Term Loan-B facility. Pricing under the new Term Loan A2 facility was 1% lower than the Term Loan-B facility and did not include a LIBOR Floor whereas, at that time, the Term Loan-B facility had a 1% LIBOR Floor (which has since been eliminated as part of the above-mentioned Third Amendment in May, 2013). During the third quarter of 2012, in connection with the extinguishment of a portion of our Term Loan-B facility, we recorded a pre-tax charge of $29 million to write-off the related portion of the Term Loan-B deferred financing costs.

The Credit Agreement, as amended, is a senior secured facility which, as of December 31, 2013, provided for an aggregate commitment amount of $3.16 billion, comprised of an $800 million revolving credit facility, a $939 million Term Loan-A facility, a $550 million Term Loan-B facility and a $872 million Term Loan-A2 facility. The revolving credit facility includes a $125 million sub-limit for letters of credit. The Credit Agreement is secured by substantially all of the assets of the Company and our material subsidiaries and guaranteed by our material subsidiaries.

Borrowings under the Credit Agreement bear interest at either (1) the ABR rate which is defined as the rate per annum equal to, at our election: 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, Term Loan-A and Term Loan-A2 borrowings and 1.25% for Term Loan B 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, Term Loan-A and Term Loan-A2 borrowings and 2.25% for Term Loan-B borrowings. The current applicable margins are 0.50% for ABR-based loans, 1.50% for LIBOR-based loans under the revolving credit, Term Loan-A and Term Loan-A2 facilities and 2.25% under the Term Loan-B facility.

As of December 31, 2013, we had no borrowings outstanding pursuant to the terms of our $800 million revolving credit facility and we had $755 million of available borrowing capacity, net of $25 million of outstanding borrowings pursuant to a short-term, on-demand credit facility and $20 million of outstanding letters of credit.

During 2013, we made scheduled principal payments of $72 million on the Term Loan-A and Term Loan A2 facilities. Quarterly installment payments (“Installment Payments”) are due on the Term Loan-A and Term Loan-A2 facilities which approximate $72 million in 2014, $77 million in 2015 and $46 million in 2016. The Installment Payments due on the Term Loan-A and Term Loan-A2 facilities during 2014 are classified as current maturities of long-term debt on our Consolidated Balance Sheet as of December 31, 2013. Although no Installment Payments are due on the Term Loan-B facility, we made optional repayments of $196 million during the fourth quarter of 2013.

In October, 2013 our $275 million accounts receivable securitization program (“Securitization”) with a group of conduit lenders and liquidity banks was amended to extend the maturity date to October 25, 2016 and reduce the interest rate spread and commitment fee. 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 December 31, 2013, we had $240 million of outstanding borrowings and $35 million of additional capacity pursuant to the terms of our accounts receivable securitization program.

Our $250 million, 7.00% senior unsecured notes (the “Unsecured Notes”) are scheduled to mature on October 1, 2018. The Unsecured Notes were issued on September 29, 2010 and registered in April, 2011. Interest on the Unsecured Note is payable semiannually in arrears on April 1st and October 1st of each year. The Unsecured Notes can be redeemed in whole at anytime subject to a make-whole call at treasury rate plus 50 basis points prior to October 1, 2014. They are also redeemable in whole or in part at a price of: (i) 103.5% on or after October 1, 2014; (ii) 101.75% on or after October 1, 2015, and; (iii) 100% on or after October 1, 2016. These Unsecured Notes are guaranteed by a group of subsidiaries (each of which is a 100% directly or indirectly owned subsidiary of Universal Health Services, Inc.) which fully and unconditionally guarantee the Unsecured Notes on a joint and several basis, subject to certain customary automatic release provisions.

On June 30, 2006, we issued $250 million of senior notes which have a 7.125% coupon rate and mature on June 30, 2016 (the “7.125% Notes”). Interest on the 7.125% Notes is payable semiannually in arrears on June 30th and December 30th of each year. In June, 2008, we issued an additional $150 million of 7.125% Notes which formed a single series with the original 7.125% Notes issued in June, 2006. Other than their date of issuance and initial price to the public, the terms of the 7.125% Notes issued in June, 2008 are identical to and trade interchangeably with, the 7.125% Notes which were originally issued in June, 2006.

In connection with the entering into of the Credit Agreement on November 15, 2010, and in accordance with the Indenture dated January 20, 2000 governing the rights of our existing notes, we entered into a supplemental indenture pursuant to which our 7.125% Notes (due in 2016) were equally and ratably secured with the lenders under the Credit Agreement with respect to the collateral for so long as the lenders under the Credit Agreement are so secured.

The average amounts outstanding during each of years 2013, 2012 and 2011 under the current and prior Credit Agreements, demand notes and accounts receivable securitization programs was $2.9 billion, with corresponding interest rates of 2.2%, 2.9% and 3.4% including commitment and facility fees. The maximum amounts outstanding at any month-end were $3.00 billion in 2013, $3.06 billion in 2012 and $3.03 billion in 2011. The effective interest rate on our current and prior Credit Agreements, accounts receivable securitization programs, and demand notes, which includes the respective interest expense, commitment and facility fees, designated interest rate swaps expense and amortization of deferred financing costs and original issue discounts, was 3.6% in 2013, 4.5% in 2012 and 4.6% in 2011.

Our 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 and dividends; and requires compliance with financial covenants including maximum leverage and minimum interest coverage ratios. We are in compliance with all required covenants as of December 31, 2013.

The carrying values of our debt at December 31, 2013 and 2012 were $3.3 billion and $3.7 billion, respectively. The fair values of our debt at December 31, 2013 and 2012 were $3.4 billion and $3.8 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.

Aggregate maturities follow:


	(000s)
2014	$	99,312
2015		139,261
2016		2,804,569
2017		1,798
2018		251,893
Later		12,241

Total	$	3,309,074

Common Stock

12 Months Ended

Dec. 31, 2013

Common Stock

5) COMMON STOCK

Dividends

Cash dividends of $.20 per share ($19.6 million in the aggregate) were declared and paid during 2013, $.60 per share ($58.4 million in the aggregate), including a $.40 per share special cash dividend ($38.9 million) were declared and paid during 2012 and $.20 per share ($19.5 million in the aggregate) were declared and paid during 2011. All classes of our common stock have similar economic rights.

Stock Repurchase Programs

In various prior years, our Board of Directors has approved stock repurchase programs authorizing us to purchase shares of our outstanding Class B Common Stock on the open market at prevailing market prices or in negotiated transactions off the market. There is no expiration date for our stock repurchase programs. The most recent approval occurred during 2007 at which time our Board of Directors authorized the purchase of up to 10 million shares, a portion of which (as reflected below) remains available for purchase as of December 31, 2013.

The following schedule provides information related to our stock repurchase programs for each of the three years ended December 31, 2013. All of the shares repurchased during 2013 and 2012 related to income tax withholding obligations resulting from the exercise of stock options and the vesting of restricted stock grants. No shares were repurchased during 2013 or 2012 pursuant to our publicly announced stock repurchase program.


	Total number of shares purchased as part of publicly announced programs		Total price paid for shares purchased as part of publicly announced programs (in thousands)		Total number of shares purchased related to stock-based compensation plans (a.)		Total price paid for shares purchased related to stock-based compensation plans (in thousands)		Aggregate number of shares purchased		Aggregate price paid for shares purchased (in thousands)		Maximum number of shares that may yet be purchased under the publicly announced program
Balance as of January 1, 2011														2,152,339
2011		1,384,637	$	50,576		217,649	$	9,906		1,602,286	$	60,482		767,702
2012		—		—		433,312	$	19,154		433,312	$	19,154		767,702
2013		—		—		427,170	$	27,201		427,170	$	27,201		767,702

Total for three year period ended December 31, 2013		1,384,637	$	50,576		1,078,131	$	56,261		2,462,768	$	106,837

(a.)

During 2013, there were 427,170 shares repurchased at an average price of $63.68 per share related to income tax withholding obligations in connection with stock-based compensation programs. During 2012, there were 432,562 shares repurchased at an average price of $44.28 per share related to income tax withholding obligations in connection with stock-based compensation programs, and 750 shares repurchased at an average of $.01 per share related to restricted shares that were forfeited by former employees pursuant to the terms of our restricted stock purchase plan. During 2011, there were 217,649 shares repurchased at an average price of $45.51 per share related to income tax withholding obligations in connection with stock-based compensation programs.

Stock-based Compensation Plans

At December 31, 2013, we have a number of stock-based employee compensation plans. Pursuant to the FASB’s guidance, we expense the grant-date fair value of stock options and other equity-based compensation pursuant to the straight-line method over the stated vesting period of the award using the Black-Scholes option-pricing model.

The expense associated with share-based compensation arrangements is a non-cash charge. In the Consolidated Statements of Cash Flows, share-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities and aggregated to $27.8 million in 2013, $22.5 million in 2012 and $18.2 million in 2011. In accordance with ASC 718, excess income tax benefits related to stock based compensation are classified as cash inflows from financing activities on the Consolidated Statement of Cash Flows. Previously for the years ended December 31, 2012 and 2011, we included $16.0 million and $7.6 million, respectively, of excess income tax benefits related to stock based compensation as net cash provided by operating activities as included in the change in accrued and deferred income taxes for each year. In our Consolidated Statements of Cash Flows, as included herein, those amounts are reflected as cash inflows from financing activities for each respective year. We assessed this misclassification and concluded that it was not material to our previously issued annual and quarterly Consolidated Statements of Cash Flows. During 2013, we generated $20.1 million of excess income tax benefits related to stock based compensation which are reflected as cash inflows from financing activities in our Consolidated Statements of Cash Flows.

Compensation costs related to outstanding stock options were recognized as follows: (i) a pre-tax charge of $25.8 million ($16.1 million after-tax) during 2013; (ii) a pre-tax charge of $20.1 million ($12.5 million after-tax) during 2012, and; (iii) a pre-tax charge of $15.8 million ($9.8 million after-tax) during 2011. In addition, during the years ended 2013, 2012 and 2011, compensation costs of $1.4 million ($853,000 after-tax), $2.3 million ($1.4 million after-tax) and $2.0 million ($1.2 million after-tax), respectively, were recognized related to restricted stock.

We adopted the 2005 Stock Incentive Plan, as amended in 2008 and 2010, (the “Stock Incentive Plan”) which replaced our Amended and Restated 1992 Stock Option Plan which expired in July of 2005. An aggregate of twenty-three million shares of Class B Common Stock has been reserved under the Stock Incentive Plan. There were 2,737,725; 2,621,161 and 2,473,500 stock options, net of cancellations, granted during 2013, 2012 and 2011, respectively. The per option weighted-average grant-date fair value of options granted during 2013, 2012 and 2011, was $13.33, $10.73 and $11.62, respectively. Stock options to purchase Class B Common Stock have been granted to our officers, key employees and directors under our above referenced stock option plans. All stock options were granted with an exercise price equal to the fair market value on the date of the grant. Options are exercisable ratably over a four-year period beginning one year after the date of the grant. All outstanding options expire five years after the date of the grant.

The fair value of each option grant was estimated on the date of grant using the Black-Scholes option-pricing model. The following weighted average assumptions were derived from averaging the number of options granted during the most recent five-year period. The weighted-average assumptions reflected below were each based upon eighteen option grants.


Year Ended December 31,	2013			2012			2011
Volatility		36	%		33	%		29	%
Interest rate		1	%		1	%		2	%
Expected life (years)		3.6			3.5			3.5
Forfeiture rate		11	%		10	%		9	%
Dividend yield		0.5	%		0.6	%		0.7	%

The risk-free rate is based on the U.S. Treasury zero coupon four year yield in effect at the time of grant. The expected life of the stock options granted was estimated using the historical behavior of employees. Expected volatility was based on historical volatility for a period equal to the stock option’s expected life. Expected dividend yield is based on our dividend yield at the time of grant.

The table below summarizes our stock option activity during each of the last three years:


Outstanding Options	Number of Shares			Average Option Price		Range (High-Low)
Balance, January 1, 2011		6,594,950		$	25.16	$	32.28 -$16.22
Granted		2,894,500		$	43.66	$	54.79 -$38.12
Exercised		(1,563,255	)	$	26.38	$	32.28 -$16.22
Cancelled		(367,250	)	$	32.60	$	46.97 -$16.22

Balance, January 1, 2012		7,558,945		$	31.63	$	54.79 -$16.22
Granted		2,966,850		$	37.01	$	44.83 -$36.95
Exercised		(2,608,007	)	$	23.22	$	46.97 -$16.22
Cancelled		(481,550	)	$	38.00	$	46.97 -$16.22

Balance, January 1, 2013		7,436,238		$	36.31	$	54.79 -$16.22
Granted		2,889,750		$	53.51	$	79.79 -$53.38
Exercised		(2,288,666	)	$	32.27	$	54.79 -$16.22
Cancelled		(416,364	)	$	43.93	$	53.38 -$16.22

Balance, December 31, 2013		7,620,958		$	43.63	$	79.79 -$30.32

Outstanding options vested and exercisable as of December 31, 2013		1,756,128		$	35.60	$	46.97 -$30.32

The following table provides information about unvested options for the year December 31, 2013:


	Shares			Weighted Average Grant Date Fair Value
Unvested options as of January 1, 2013		5,250,926		$	10.74
Granted		2,889,750		$	13.33
Vested		(1,864,982	)	$	10.22
Cancelled		(410,864	)	$	11.66

Unvested options as of December 31, 2013		5,864,830		$	12.12

The following table provides information about all outstanding options, and exercisable options, at December 31, 2013:


	Options Outstanding		Options Exercisable
Number		7,620,958		1,756,128
Weighted average exercise price	$	43.64	$	35.60
Aggregate intrinsic value as of December 31, 2013	$	286,740,433	$	80,189,277
Weighted average remaining contractual life		2.9		1.6

The total in-the-money value of all stock options exercised during the years ended December 31, 2013, 2012 and 2011 were $70.9 million, $54.4 million and $28.9 million, respectively.

The weighted average remaining contractual life for options outstanding and weighted average exercise price per share for exercisable options at December 31, 2013 were as follows:


	Options Outstanding		Exercisable Options		Expected to Vest Options (a)
Exercise Price	Shares		Weighted Average Exercise Price Per Share		Weighted Average Remaining Contractual Life (in Years)		Shares		Weighted Average Exercise Price Per Share		Shares		Weighted Average Exercise Price Per Share
$30.32 – $36.95		3,183,583	$	35.14		2.4		1,259,453	$	32.45		1,716,901	$	36.91
$38.12 – $43.67		1,685,350		43.56		2.1		496,175		43.58		1,061,101		43.55
$44.83 – $53.38		2,724,525		53.36		4.0		500		46.97		2,430,648		53.36
$54.79 – $79.79		27,500		67.64		4.0		0		N/A		24,538		67.64

Total		7,620,958	$	43.63		2.9		1,756,128	$	35.60		5,233,188	$	46.04

(a)	Assumes a weighted average forfeiture rate of 10.8%.

In addition to the Stock Incentive Plan, we have the following stock incentive and purchase plans: (i) the 2010 Employees’ Restricted Stock Purchase Plan (“2010 Plan”), which replaced the Second Amended and Restated 2001 Employees’ Restricted Stock Purchase Plan (“2001 Plan”), which allows eligible participants to purchase shares of Class B Common Stock at par value, subject to certain restrictions, and; (ii) a 2005 Employee Stock Purchase Plan which allows eligible employees to purchase shares of Class B Common Stock at a ten percent discount. There were 90,587, 117,901 and 98,366 shares issued pursuant to the Employee Stock Purchase Plan during 2013, 2012 and 2011, respectively. Compensation expense recorded in connection with this plan was $581,000, $533,000 and $461,000 during 2013, 2012 and 2011, respectively.

We have reserved 6.0 million shares of Class B Common Stock for issuance under these various plans (excluding terminated plans) and have issued approximately 1.0 million shares, net of cancellations, pursuant to the terms of these plans (excluding terminated plans) as of December 31, 2013.

During 2013, pursuant to the 2010 Plan, the Compensation Committee (“Committee”) approved the issuance of 10,000 restricted shares of our Class B Common Stock at a weighted average price of $80.36 per share ($803,600 in the aggregate) to various employees. These shares are scheduled to vest ratably on the first, second, third and fourth anniversaries of the grant date. We recorded compensation expense of approximately $41,000 during 2013 in connection with this grant. The remaining expense associated with these awards (estimated at approximately $760,000 as of December 31, 2013) will be recorded over the remaining vesting periods of the awards, assuming the recipients remain employed by us.

During 2012, pursuant to the 2010 Plan, the Committee approved the issuance of 54,127 restricted shares of our Class B Common Stock at a weighted average price of $36.95 per share ($2.0 million in the aggregate) to our CEO and Chairman of the Board. These shares are scheduled to vest as follows: 50% on the first anniversary date of the grant, and 25% on each of the second and third anniversary dates of the grant, assuming our CEO remains employed by us. In the event that our CEO’s employment is terminated for reasons other than death, disability or retirement, any unvested shares will be forfeited, unless otherwise specified in a separation agreement between us and our CEO. 27,063 of these shares became fully vested during 2013. In connection with this grant, we recorded compensation expense of approximately $523,000 during 2013 and approximately $1 million during 2012. The remaining expense associated with these awards (estimated at approximately $500,000 as of December 31, 2013) will be recorded over the remaining vesting periods of the awards, assuming the recipient remain employed by us.

During 2011, pursuant to the 2010 Plan, the Committee approved the issuance of 21,500 restricted shares of our Class B Common Stock at a weighted average price of $53.21 per share ($1.1 million in the aggregate) to various employees, of which 10,000 of these shares became fully vested during 2013. During 2012, 750 of these shares became fully vested and 750 of these shares were cancelled. The remaining 10,000 shares are scheduled to vest on the third anniversary of the grant date. We recorded compensation expense of $354,000 during 2013, $370,000 during 2012 and $198,000 during 2011 in connection with these grants. The remaining expense associated with these awards (estimated at $183,000 as of December 31, 2013) will be recorded over the remaining vesting period of the awards, assuming the recipients remain employed by us.

The 2001 Plan, as described above, expired in March, 2010. Under this plan, we had 2.4 million shares of Class B Common Stock reserved for issuance and have issued approximately 1.2 million shares, net of cancellations, pursuant to the terms of this plan as of December 31, 2010, of which 39,831 became fully vesting during 2013, 62,044 became fully vested during 2012 and 78,133 became fully vested during 2011.

During the first quarter of 2010, pursuant to the 2001 Plan and prior to its expiration, the Committee approved the issuance of 49,472 restricted shares of our Class B Common Stock at $30.32 per share ($1.5 million in the aggregate) to our CEO and Chairman of the Board. These shares, which were issued pursuant to a provision in our CEO’s employment agreement, are scheduled to vest ratably on the first, second, third and fourth anniversary dates of the grant, assuming our CEO remains employed by us. In the event that our CEO’s employment is terminated by reason of disability, death, without proper cause or due to breach of the CEO’s employment agreement by us, the vesting of these awards will occur immediately. 12,368 of these shares became fully vested in each of 2013, 2012 and 2011. In connection with this grant, we recorded compensation expense of $375,000 in each of 2013, 2012 and 2011 and $355,000 during 2010, and the remaining expense associated with this award (estimated at $20,000 as of December 31, 2013) will be recorded over the remaining vesting period of the award.

During the first quarter of 2009, pursuant to the 2001 Plan, the Committee approved the issuance of 109,850 restricted shares of our Class B Common Stock at $20.26 per share ($2.2 million in the aggregate) to our CEO. These shares are scheduled to vest ratably on the first, second, third and fourth anniversary dates of the grant and are subject to the same conditions and terms as mentioned above in connection with the grant of restricted shares during the first quarter of 2010. 27,463 of these shares became fully vested in 2013, 27,462 of these shares became fully vested in each of 2012 and 2011 and 27,463 of these shares became fully vested in 2010. In connection with this grant, we recorded compensation expense of approximately $74,000 during 2013, $556,000 during each of 2012, 2011 and 2010 and $482,000 during 2009. This award was fully vested at December 31, 2013.

During the first quarter of 2008, pursuant to the 2001 Plan, the Committee approved the issuance of 62,190 restricted shares of our Class B Common Stock at $24.12 per share ($1.5 million in the aggregate) to our CEO. These shares were scheduled to vest ratably on the first, second, third and fourth anniversary dates of the grant and were subject to the same conditions and terms as mentioned above in connection with the grant of restricted shares during the first quarter of 2010. 15,548 and 15,546 of these shares became fully vesting during 2012 and 2011, respectively, and 15,548 of these shares became fully vested in each of 2010 and 2009. In connection with this grant, we recorded compensation expense of $15,000 during 2012 and $375,000 during 2011. This award was fully vested at December 31, 2012.

During the fourth quarter of 2007, pursuant to the 2001 Plan, the Committee approved the issuance of 61,362 restricted shares of our Class B Common Stock at $24.45 per share ($1.5 million in the aggregate) to our CEO. These shares were scheduled to vest ratably on the first, second, third and fourth anniversary dates of the grant and were subject to the same conditions and terms as mentioned above in connection with the grant of restricted shares during the first quarter of 2010. 15,341 of these shares became fully vested in each of 2011 and 2010 and 15,340 of these shares became fully vested in each of 2009 and 2008. In connection with this grant, we recorded compensation expense of $333,000 during 2011 and $375,000 during 2010. This award was fully vested at December 31, 2011.

Additionally, during 2007, pursuant to the 2001 Plan, the Committee approved the issuance of 22,250 restricted shares of our Class B Common stock at a weighted average of $29.62 per share ($659,000 in the aggregate) to various employees. These shares had various vesting schedules. We recorded compensation expense of $42,000 during 2012 and $120,000 during 2011, in connection with these grants. These awards were fully vested at December 31, 2012.

At December 31, 2013, 25,657,523 shares of Class B Common Stock were reserved for issuance upon conversion of shares of Class A, C and D Common Stock outstanding, for issuance upon exercise of options to purchase Class B Common Stock and for issuance of stock under other incentive plans. Class A, C and D Common Stock are convertible on a share for share basis into Class B Common Stock.

In connection with the long-term incentive plans described above, we recorded compensation expense of $2.0 million in 2013, $2.8 million in 2012 and $2.4 million in 2011. Including the compensation expense recognized related to outstanding stock options of $25.8 million in 2013, $20.1 million in 2012 and $15.8 million in 2011, we recorded a total stock compensation expense of $27.8 million in 2013, $22.5 million in 2012 and $18.2 million in 2011.

Income Taxes

12 Months Ended

Dec. 31, 2013

Income Taxes

6) INCOME TAXES

Components of income tax expense/(benefit) are as follows (amounts in thousands):


	Year Ended December 31,
	2013		2012			2011
Current
Federal	$	256,545	$	254,021		$	165,409
Foreign		1,655		9,084			300
State		28,490		39,076			22,901

		286,690		302,181			188,610
Deferred
Federal and foreign		25,341		(21,408	)		53,056
State		3,278		(6,157	)		5,800

		28,619		(27,565	)		58,856

Total	$	315,309	$	274,616		$	247,466

Deferred taxes are required to be classified based on the financial statement classification of the related assets and liabilities which give rise to temporary differences. Deferred taxes result from temporary differences between the financial statement carrying amounts and the tax bases of assets and liabilities. The components of deferred taxes are as follows (amounts in thousands):


	Year Ended December 31,
	2013			2012
Deferred income tax assets:
Self-insurance reserves	$	87,483		$	112,587
Compensation accruals		49,302			47,571
State and foreign net operating loss carryforwards and other state and foreign deferred tax assets		57,204			54,874
Other currently non-deductible accrued liabilities		24,587			29,934
Net pension liability—OCI only		6,390			12,061
Doubtful accounts and other reserves		33,905			17,562
Other combined items—OCI only		9,018			15,282

		267,889			289,871
Less: Valuation Allowance		(46,841	)		(44,511	)

Net deferred income tax assets:		221,048			245,360
Deferred income tax liabilities:
Depreciable and amortizable assets		(337,669	)		(322,317	)
Other deferred tax liabilities		(2,624	)		(2,329	)

Net deferred income tax liabilities	$	(119,245	)	$	(79,286	)

There was no material impact of deferred taxes recorded in conjunction with the acquisition of Ascend Health Corporation.

The effective tax rates, as calculated by dividing the provision for income taxes by income before income taxes, were as follows for each of the years ended December 31, 2013, 2012 and 2011 (dollar amounts in thousands):


	2013			2012			2011
Provision for income taxes	$	315,309		$	274,616		$	247,466
Income before income taxes		869,332			763,663			696,336

Effective tax rate		36.3	%		36.0	%		35.5	%

Impacting the effective tax rates during 2013, 2012 and 2011 were favorable discrete tax items of approximately $1 million recorded during each year to adjust the estimated liabilities for uncertain tax positions.

A reconciliation between the federal statutory rate and the effective tax rate is as follows:


	Year Ended December 31,
	2013			2012			2011
Federal statutory rate		35.0	%		35.0	%		35.0	%
State taxes, net of federal income tax benefit		2.5			3.0			2.9
Nondeductible transaction costs		—			0.2			—
Divestiture Gain		0.3			—			—
Other items		0.4			0.1			0.4
Impact of income attributable to noncontrolling interests		(1.9	)		(2.3	)		(2.8	)

Effective tax rate		36.3	%		36.0	%		35.5	%

Included in “Other current assets” on our Consolidated Balance Sheet are prepaid federal, foreign, and state income taxes amounting to approximately $5 million and $7 million as of December 31, 2013 and 2012, respectively.

The net deferred tax assets and liabilities are comprised as follows (amounts in thousands):


	Year Ended December 31,
	2013			2012
Current deferred taxes
Assets	$	121,097		$	105,639
Liabilities		(1,194	)		(1,178	)

Total deferred taxes-current		119,903			104,461

Noncurrent deferred taxes
Assets		103,221			142,065
Liabilities		(342,369	)		(325,812	)

Total deferred taxes-noncurrent		(239,148	)		(183,747	)

Total deferred tax liabilities	$	(119,245	)	$	(79,286	)

The assets and liabilities classified as current relate primarily to the allowance for uncollectible patient accounts, compensation-related accruals and the current portion of the temporary differences related to self- insurance reserves. At December 31, 2013, state net operating loss carryforwards (expiring in years 2014 through 2033), and credit carryforwards available to offset future taxable income approximated $959 million, representing approximately $47 million in deferred state tax benefit (net of the federal benefit). At December 31, 2013, there were foreign net operating loss carryforwards of approximately $8 million expiring through 2021 representing approximately $3 million in deferred foreign tax benefit.

A valuation allowance is required when it is more likely than not that some portion of the deferred tax assets will not be realized. Based on available evidence, it is more likely than not that certain of our state tax benefits will not be realized. Therefore, valuation allowances of approximately $44 million and $41 million have been reflected as of December 31, 2013 and 2012, respectively. During 2013, the valuation allowance on these state tax benefits increased by approximately $3 million due to additional net operating losses incurred. In addition, valuation allowances of approximately $3 million have been reflected as of December 31, 2013 and 2012 related to foreign net operating losses. There were no significant increases in valuation allowances as a result of the acquisition of Ascend Health Corporation.

We adopted the provisions of Accounting for Uncertainty in Income Taxes effective January 1, 2007. During 2013 and 2012, the estimated liabilities for uncertain tax positions (including accrued interest and penalties) were increased less than $1 million due to tax positions taken in the current and prior years. During 2013, the estimated liabilities for uncertain tax positions (including accrued interest and penalties) were reduced due to the lapse of the statute of limitations resulting in a net income tax benefit of approximately $1 million. The balance at each of December 31, 2013 and 2012, if subsequently recognized, that would favorably affect the effective tax rate and the provision for income taxes is approximately $2 million and $4 million, respectively.

We recognize accrued interest and penalties associated with uncertain tax positions as part of the tax provision. As of December 31, 2013 and 2012, we have accrued interest and penalties of less than $1 million as of each date. The U.S. federal statute of limitations remains open for the 2010 and subsequent years. Foreign and U.S. state and local jurisdictions have statutes of limitations generally ranging for 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 unrecognized 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.

The tabular reconciliation of unrecognized tax benefits for the years ended December 31, 2013, 2012 and 2011 is as follows (amounts in thousands).


	As of December 31,
	2013			2012			2011
Balance at January 1,	$	6,824		$	7,403		$	7,923
Additions based on tax positions related to the current year		50			200			750
Additions for tax positions of prior years		283			386			419
Reductions for tax positions of prior years		(1,260	)		(1,165	)		(1,628	)
Settlements		(2,528	)		—			(61	)

Balance at December 31,	$	3,369		$	6,824		$	7,403

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References+ Details

Lease Commitments

12 Months Ended

Dec. 31, 2013

Lease Commitments

7) LEASE COMMITMENTS

Four of our hospital facilities are held under operating leases with Universal Health Realty Income Trust with terms expiring in 2014 and 2016 (see Note 9 for additional disclosure). We also lease the real property of certain facilities acquired by us in connection with the acquisition of PSI in November, 2010 and the acquisition of Ascend in October, 2012 (see Item 2. Properties for additional disclosure).

A summary of property under capital lease follows (amounts in thousands):


	As of December 31,
	2013			2012
Land, buildings and equipment	$	27,636		$	27,836
Less: accumulated amortization		(27,382	)		(26,540	)

	$	254		$	1,296

Future minimum rental payments under lease commitments with a term of more than one year as of December 31, 2013, are as follows (amounts in thousands):


Year	Capital Leases			Operating Leases
	(000s)
2014	$	2,026		$	55,812
2015		1,218			45,807
2016		1,167			37,769
2017		1,077			21,391
2018		1,086			17,322
Later years		4,030			128,636

Total minimum rental	$	10,604		$	306,737

Less: Amount representing interest		(3,971	)

Present value of minimum rental commitments		6,633
Less: Current portion of capital lease obligations		(774	)

Long-term portion of capital lease obligations	$	5,859

We incurred no additional capital lease obligations during 2013, 2012 or 2011. In the ordinary course of business, our facilities routinely lease equipment pursuant to new lease arrangements that will likely result in future lease and rental expense in excess of amounts indicated above.

- Definition

The entire disclosure for lessee entity's leasing arrangements including, but not limited to, all of the following: (a.) The basis on which contingent rental payments are determined, (b.) The existence and terms of renewal or purchase options and escalation clauses, (c.) Restrictions imposed by lease agreements, such as those concerning dividends, additional debt, and further leasing.

+ References+ Details

Commitments and Contingencies

12 Months Ended

Dec. 31, 2013

Commitments and Contingencies

8) COMMITMENTS AND CONTINGENCIES

Professional and General Liability, Workers’ Compensation Liability and Property Insurance

Professional and General Liability and Workers Compensation Liability:

Effective January 1, 2008, most of our subsidiaries became self-insured for professional and general liability exposure up to $10 million per occurrence. Prior to our acquisition of Psychiatric Solutions, Inc. (“PSI”) in November, 2010, our subsidiaries purchased several excess policies through commercial insurance carriers which provide for coverage in excess of $10 million up to $200 million per occurrence and in the aggregate. However, we are liable for 10% of the claims paid pursuant to the commercially insured coverage in excess of $10 million up to $60 million per occurrence and in the aggregate.

Prior to our acquisition in November, 2010, the PSI subsidiaries were commercially insured for professional and general liability insurance claims in excess of a $3 million self-insured retention to a limit of $75 million. PSI utilized its captive insurance company and that captive insurance company remains in place after our acquisition of PSI to manage the self-insured retention for all former PSI subsidiaries for claims incurred prior to January 1, 2011. The captive insurance company also continues to insure all professional and general liability claims, regardless of date incurred, for the former PSI subsidiaries located in Florida and Puerto Rico.

Since our acquisition of PSI on November 15, 2010, the former PSI subsidiaries are self-insured for professional and general liability exposure up to $3 million per occurrence and our legacy subsidiaries (which are not former PSI subsidiaries) are self-insured for professional and general liability exposure up to $10 million per occurrence. Effective November, 2010, our subsidiaries (including the former PSI subsidiaries) were provided with several excess policies through commercial insurance carriers which provide for coverage in excess of the applicable per occurrence self-insured retention (either $3 million or $10 million) up to $250 million per occurrence and in the aggregate. We remain liable for 10% of the claims paid pursuant to the commercially insured coverage in excess of $10 million up to $60 million per occurrence and in the aggregate. The 9 behavioral health facilities acquired from Ascend Health Corporation in October, 2012 have general and professional liability policies through commercial insurance carriers which provide for up to $20 million of aggregate coverage, subject to a $25,000 per occurrence deductible. These facilities, like our other facilities, are also provided excess coverage through commercial insurance carriers for coverage in excess of the underlying commercial policy limitations up to $250 million per occurrence and in the aggregate.

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.

As of December 31, 2013, the total accrual for our professional and general liability claims was $206 million, of which $44 million is included in current liabilities. As of December 31, 2012, the total accrual for our professional and general liability claims was $279 million, of which $48 million is included in current liabilities.

We recorded reductions to our professional and general liability self-insurance reserves (relating to prior years) amounting to $81 million during 2013, $27 million during 2012 and $11 million during 2011. The favorable change in our estimated future claims payments recorded during 2013, relating to years prior to 2013, were due primarily to: (i) an increased weighting given to company-specific metrics (to 100% from 75%), and decreased general industry metrics (to 0% from 25%), related to projected incidents per exposure, historical claims experience and loss development factors; (ii) historical data which measured the realized favorable impact of medical malpractice tort reform experienced in several states in which we operate, and; (iii) a decrease in claims related to certain higher risk specialties (such as obstetrical) due to a continuation of the company-wide patient safety initiative undertaken during the last several years. As the number of our facilities and our patient volumes have increased, thereby providing for a statistically significant data group, and taking into consideration our long-history of company-specific risk management programs and claims experience, our reserve analyses have included a greater emphasis on our historical professional and general liability experience which has developed favorably as compared to general industry trends. The favorable change recorded during 2012 resulted from favorable changes in our estimated future claims payments pursuant to a reserve analysis. The favorable change recorded during 2011 consisted primarily of third-party recoveries and reserve reductions in connection with PHICO–related claims which we became liable for upon PHICO’s (a former commercial insurance carrier) liquidation in 2002.

As of December 31, 2013, the total accrual for our workers’ compensation liability claims was $64 million, of which $34 million is included in current liabilities. As of December 31, 2012, the total accrual for our workers’ compensation liability claims was $66 million, of which $35 million is included in current liabilities. The adjustments recorded during the last three years to our prior year reserves for workers’ compensation claims did not have a material impact on our consolidated results of operations for the years ended December 31, 2013, 2012 or 2011.

Property Insurance:

We have commercial property insurance policies covering catastrophic losses, including windstorm damage, up to a $1 billion policy limit per occurrence, subject to a $250,000 deductible for the majority of our properties (the properties acquired from Psychiatric Solutions, Inc. are subject to a $50,000 deductible). Losses resulting from named windstorms are subject to deductibles between 3% and 5% of the declared 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). Our earthquake limit is $250 million, subject to a deductible of $250,000, except for facilities located within documented fault zones. Earthquake losses that affect facilities located in fault zones within the United States are subject to a $100 million limit and will have applied deductibles ranging from 1% to 5% of the declared total insurable value of the property. The earthquake limit in Puerto Rico is $25 million, subject to a $25,000 deductible. Non-critical flood losses have either a $250,000 or $500,000 deductible, based upon the 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 to cover a substantial portion of the applicable deductible.

Legal Proceedings

We are subject to claims and suits in the ordinary course of business, including those arising from care and treatment afforded by our hospitals and are party to litigation, as outlined below.

Office of Inspector General (“OIG”) and Other Government Investigations

In September, 2010, we, along with many other companies in the healthcare industry, received a letter from the United States Department of Justice (“DOJ”) advising of a False Claim Act investigation being conducted in connection with the implantation of implantable cardioverter defibrillators (“ICDs”) from 2003 to 2010 at several of our acute care facilities. The DOJ alleges that ICDs were implanted and billed by our facilities in contravention of a National Coverage Determination regarding these devices. We have established a reserve in connection with this matter which did not have a material impact on our consolidated financial statements.

In July, 2012, one of our subsidiaries, Peachford Behavioral Health System of Atlanta located in Atlanta, Georgia, received a subpoena from the OIG for the Department of Health and Human Services requesting various documents. We have provided all requested documents. During the fourth quarter of 2013, we were notified that the governmental agencies investigating this matter had declined to proceed.

In February, 2013, the 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 several UHS owned 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 receiving this subpoena: (i) the Keys of Carolina and Old Vineyard received notification during the second half of 2012 from the United States Department of Justice of its intent to proceed with an investigation following requests for documents for the period of January, 2007 to October, 2012 from the North Carolina state Attorney General’s Office; (ii) Harbor Point Behavioral Health Center received a subpoena in December, 2012 from the Attorney General of the Commonwealth of Virginia requesting various documents from July, 2006 to the date of the subpoena, and; (iii) The Meadows Psychiatric Center received a subpoena from the OIG in February, 2013 requesting certain documents from 2008 to the date of the subpoena. Unrelated to these matters, the Keys of Carolina was closed and the real property was sold in January, 2013. In April, 2013, the OIG served facility specific subpoenas on Wekiva Springs Center and River Point Behavioral Health requesting various documents from January, 2005 to the present. In June, 2013, the OIG served a subpoena on Coastal Harbor Health System in Savannah, Georgia requesting documents from January, 2009 to the date of the subpoena. In July, 2013, another subpoena was issued to Wekiva Springs Center and River Point Behavioral Health requesting additional records. We have been advised by the DOJ’s Criminal Frauds Section that they have received a referral from the DOJ Civil Division and have opened an investigation of River Point Behavioral Health and Wekiva Springs Center. In February, 2014, we were notified that the investigation conducted by the Criminal Frauds Section has been expanded to include the National Deaf Academy. At present, we are uncertain as to the focus, scope or extent of the investigations, liability of the facilities and/or potential financial exposure, if any, in connection with these matters.

Matters Relating to PSI:

The following matters pertain to PSI or former PSI facilities (owned by subsidiaries of Psychiatric Solutions, Inc.) 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:

Garden City Employees’ Retirement System v. PSI:

This is a purported shareholder class action lawsuit filed in the United States District Court for the Middle District of Tennessee against PSI and the former directors in 2009 alleging violations of federal securities laws. We intend to defend the case vigorously. Should we be deemed liable in this matter, we believe we would be entitled to commercial insurance recoveries for amounts paid by us, subject to certain limitations and deductibles. Included in our consolidated balance sheets as of December 31, 2013 and 2012, is an estimated reserve (current liability) and corresponding commercial insurance recovery (current asset) which did not have a material impact on our financial statements. Although we believe the commercial insurance recoveries are adequate to satisfy potential liability and related legal fees in connection with this matter, we can provide no assurance that the ultimate liability will not exceed the commercial insurance recoveries which would make us liable for the excess.

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 have been 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 been collected and delivered to the DOJ. 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 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. 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.

Virginia Department of Medical Assistance Services Recoupment Claims:

The Virginia Department of Medical Assistance Services (“DMAS”) has conducted audits at seven former PSI Residential Treatment Centers operated in the Commonwealth of Virginia to confirm compliance with provider rules under the state’s Medicaid Provider Services Manual (“Manual”). As a result of those audits, DMAS claims the facilities failed to comply with the requirements of the Manual and has requested repayment of Medicaid payments to those facilities. PSI had previously filed appeals to repayment demands at each facility which are currently pending. We had previously agreed to a settlement of this matter which was approved by Virginia state officials during the first quarter of 2014. The aggregate refund of Medicaid payments made to those facilities, as requested by DMAS, and the settlement amount is not material to our consolidated financial position or results of operations.

General:

The healthcare industry is subject to numerous laws and regulations which include, among other things, matters such as government healthcare participation requirements, various licensure, certifications, and accreditations, reimbursement for patient services, and Medicare and Medicaid fraud and abuse. Government action has increased with respect to investigations and/or allegations concerning possible violations of fraud and abuse and false claims statutes and/or regulations by healthcare providers. Currently, and from time to time, some of our facilities are subjected to inquiries and/or actions and receive notices of potential non-compliance of laws and regulations from various federal and state agencies. Providers that are found to have violated these laws and regulations may be excluded from participating in government healthcare programs, subjected to potential licensure, certification, and/or accreditation revocation, subjected to fines or penalties or required to repay amounts received from the government for previously billed patient services. We monitor all aspects of our business and have developed a comprehensive ethics and compliance program that is designed to meet or exceed applicable federal guidelines and industry standards. Because the law in this area is complex and constantly evolving, governmental investigation or litigation may result in interpretations that are inconsistent with industry practices, including ours. Although we believe our policies, procedures and practices comply with governmental regulations, there is no assurance that we will not be faced with sanctions, fines or penalties in connection with such inquiries or actions, including with respect to the investigations and other matters discussed herein. Even if we were to ultimately prevail, such inquiries and/or actions could have a material adverse effect on us.

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 specifically described above 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 proceeding 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.

In addition, various suits and claims arising against us in the ordinary course of business are pending. In the opinion of management, the outcome of such claims and litigation will not materially affect our consolidated financial position or results of operations.

In addition to our long-term debt obligations as discussed in Note 4-Long-Term Debt and our operating lease obligations as discussed in Note 7-Lease Commitments, we have various other contractual commitments outstanding as of December 31, 2013 as follows: (i) other combined estimated future purchase obligations of $261 million related to a long-term contract with third-parties consisting primarily of certain revenue cycle data processing services for our acute care facilities ($76 million), expected future costs to be paid to a third-party vendor in connection with the purchase, implementation and on-going operation of an electronic health records application for each of our acute care facilities ($149 million), purchase commitment expected to be incurred in 2014 related to certain equipment for our acute care hospitals ($33 million) and estimated minimum liabilities for physician commitments expected to be paid in the future ($3 million); (ii) estimated construction commitment of $153 million made to a third-party for construction of a new acute care hospital located in Henderson, Nevada, and; (iii) combined estimated future payments of $223 million related to our non-contributory, defined benefit pension plan ($205 million consisting of estimated payments through 2088) and other retirement plan liabilities ($17 million).

As of December 31, 2013 we were party to certain off balance sheet arrangements consisting of standby letters of credit and surety bonds which totaled $85 million consisting of: (i) $69 million related to our self-insurance programs, and; (ii) $16 million of other debt and public utility guarantees.

- Definition

The entire disclosure for commitments and contingencies.

+ References+ Details

Relationship with Universal Health Realty Income Trust and Related Party Transactions

12 Months Ended

Dec. 31, 2013

Relationship with Universal Health Realty Income Trust and Related Party Transactions

9) RELATIONSHIP WITH UNIVERSAL HEALTH REALTY INCOME TRUST AND RELATED PARTY TRANSACTIONS

Relationship with Universal Health Realty Income Trust:

At December 31, 2013, we held approximately 6.1% 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 $2.4 million during 2013, $2.1 million during 2012 and $2.0 million during 2011.

Our pre-tax share of income from the Trust was $842,000 during 2013, $1.2 million during 2012 and $4.6 million during 2011, and is included in net revenues in the accompanying consolidated statements of income for each year. Included in our share of the Trust’s income for 2012 and 2011 was approximately $500,000 in 2012 and $3.7 million in 2011 related to our share of the net favorable impact realized by the Trust in connection with: (i) gains on the sale of medical office buildings (in 2012 and 2011), and; (ii) gain on fair value recognition resulting from the Trust’s purchase of minority ownership interests in majority owned limited liability companies partially offset by a provision for asset impairment (in 2011).

The carrying value of our investment in the Trust was $8.1 million and $9.3 million at December 31, 2013 and 2012, respectively, and is included in other assets in the accompanying consolidated balance sheets. The market value of our investment in the Trust was $31.5 million at December 31, 2013 and $39.9 million at December 31, 2012, based on the closing price of the Trust’s stock on the respective dates.

Total rent expense under the operating leases on the four hospital facilities with the Trust (as discussed below) was $16.4 million during 2013 and $16.3 million during each of 2012 and 2011. In addition, certain of our subsidiaries are tenants in several medical office buildings owned by limited liability companies in which the Trust holds either 100% of the ownership interest or various noncontrolling, majority ownership interests.

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 our subsidiaries are unconditionally guaranteed by us and are cross-defaulted with one another.

Pursuant to the terms of the 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. 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. We also have the right to purchase the respective leased facilities 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 four leased hospital properties at their appraised fair market value upon one month’s notice should a change of control of the Trust occur.

The table below details the remaining renewal options and terms for each of our four hospital facilities leased from the Trust:

Hospital Name

Type of Facility

Annual
Minimum
Rent

End of Lease Term

Renewal
Term
(years)

McAllen Medical Center

Acute Care

5,485,000

December, 2016

(a)

Wellington Regional Medical Center

Acute Care

3,030,000

December, 2016

(b)

Southwest Healthcare System, Inland Valley Campus

Acute Care

2,648,000

December, 2016

(b)

The Bridgeway

Behavioral Health

930,000

December, 2014

(c)

(a)	We have three 5-year renewal options at existing lease rates (through 2031).

(b)	We have one 5-year renewal options at existing lease rates (through 2021) and two 5-year renewal options at fair market value lease rates (2022 through 2031).

(c)	We have two 5-year renewal options at fair market value lease rates (2015 through 2024).

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 our chief executive officer (“CEO”) and his wife. As a result of these agreements, based on actuarial tables and other assumptions, during the life expectancies of the insureds, we would pay approximately $25 million in premiums, and certain trusts owned by our chief executive officer, would pay approximately $8 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 $33 million representing the $25 million of aggregate premiums paid by us as well as the $8 million of aggregate premiums paid by the trusts. During 2013 we paid approximately $1.3 million in premium payments and during each of 2012 and 2011, we paid approximately $1.4 million in premium payments. These agreements did not have a material effect on our consolidated financial statements or results of operations during 2013, 2012 or 2011.

A member of our Board of Directors and member of the Executive Committee is Of Counsel to the law firm used by us as our principal outside counsel. This Board member is also the trustee of certain trusts for the benefit of our CEO and his family. This law firm also provides personal legal services to our CEO.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References+ Details

Pension Plan

12 Months Ended

Dec. 31, 2013

Pension Plan

10) PENSION PLAN

We maintain contributory and non-contributory retirement plans for eligible employees. Our contributions to the contributory plan amounted to $29.9 million, $27.3 million and $21.7 million in 2013, 2012 and 2011, respectively. The non-contributory plan is a defined benefit pension plan which covers employees of one of our subsidiaries. The benefits are based on years of service and the employee’s highest compensation for any five years of employment. Our funding policy is to contribute annually at least the minimum amount that should be funded in accordance with the provisions of ERISA.

The following table shows the reconciliation of the defined benefit pension plan as of December 31, 2013 and 2012:


	2013			2012
	(000s)
Change in plan assets:
Fair value of plan assets at beginning of year	$	104,074		$	87,940
Actual return (loss) on plan assets		8,037			13,824
Employer contributions		0			7,786
Benefits paid		(5,042	)		(4,946	)
Administrative expenses		(600	)		(530	)

Fair value of plan assets at end of year	$	106,469		$	104,074
Change in benefit obligation:
Benefit obligation at beginning of year	$	114,529		$	108,446
Service cost		1,060			1,144
Interest cost		4,528			4,659
Benefits paid		(5,042	)		(4,946	)
Actuarial (gain) loss		(11,517	)		5,226

Benefit obligation at end of year	$	103,558		$	114,529
Amounts recognized in the Consolidated Balance Sheet:
Other non-current assets	$	2,911		$	0
Other non-current liabilities		0			10,455

Total amounts recognized at end of year	$	2,911		$	10,455


	2013			2012			2011
	(000s)
Components of net periodic cost (benefit)
Service cost	$	1,060		$	1,144		$	1,162
Interest cost		4,528			4,659			5,047
Expected return on plan assets		(7,601	)		(7,301	)		(6,566	)
Recognized actuarial loss		3,305			4,219			2,427

Net periodic cost	$	1,292		$	2,721		$	2,070


	2013		2012
Measurement Dates
Benefit obligations		12/31/2013		12/31/2012
Fair value of plan assets		12/31/2013		12/31/2012


	2013			2012
Weighted average assumptions as of December 31
Discount rate		4.95	%		4.05	%
Rate of compensation increase		4.00	%		4.00	%


	2013			2012			2011
Weighted-average assumptions for net periodic benefit cost calculations
Discount rate		4.05	%		4.40	%		5.54	%
Expected long-term rate at return on plan assets		7.50	%		8.00	%		8.00	%
Rate of compensation increase		4.00	%		4.00	%		4.00	%

The accumulated benefit obligation was $102.3 million and $112.7 million as of December 31, 2013 and 2012, respectively. As of December 31, 2013, the fair value of plan assets exceeded the accumulated benefit obligation by $4.1 million. As of December 31, 2012, the accumulated benefit obligation exceeded the fair value of plan assets by $8.6 million.

We estimate that there will be a $1.1 million net loss amortized from accumulated other comprehensive income during 2014.

The market values of our pension plan assets at December 31, 2013 and December 31, 2012 by asset category are as follows:


December 31, 2013	Total		Level 1		Level 2		Level 3
Equities:
U.S. Large Cap	$	8,600	$	—	$	8,600	$	—
U.S. Mid Cap		2,740		—		2,740		—
U.S. Small Cap		2,725		—		2,725		—
International Developed		6,508		—		6,508		—
Emerging Markets		4,154		—		4,154		—
Fixed income:
Core Fixed Income		23,222		—		23,222		—
Long Duration Fixed Income		55,933		—		55,933		—
Real Estate:
REIT Fund		2,124		—		2,124		—
Cash/Currency:
Cash Equivalents		463		—		463		—

Total market value	$	106,469	$	—	$	106,469	$	—


December 31, 2012	Total		Level 1		Level 2		Level 3
Equities:
U.S. Large Cap	$	22,800	$	—	$	22,800	$	—
U.S. Mid Cap		1,566		—		1,566		—
U.S. Small-Mid Cap		7,738		—		7,738		—
U.S. Small Cap		1,583		—		1,583		—
International Developed		10,779		—		10,779		—
Emerging Markets		3,912		—		3,912		—
Fixed income:
Long Duration Fixed Income		51,355		—		51,355		—
Real Estate:
REIT Fund		3,904		—		3,904		—
Cash/Currency:
Cash Equivalents		437		—		437		—

Total market value	$	104,074	$	—	$	104,074	$	—

To develop the expected long-term rate of return on plan assets assumption, we considered the historical returns and the future expectations for returns for each asset class, as well as the target asset allocation of the pension portfolio.

The following table shows expected benefit payments for the years ended December 31, 2013 through 2023 for our defined pension plan. There will be benefit payments under this plan beyond 2023.


Estimated Future Benefit Payments (000s)
2014	$	5,677
2015		5,966
2016		6,205
2017		6,407
2018		6,612
2019-2023		34,931

Total	$	65,798


	2013			2012
Plan Assets
Asset Category
Equity securities		23	%		47	%
Fixed income securities		74	%		49	%
Other		3	%		4	%

Total		100	%		100	%

Investment Policy, Guidelines and Objectives have been established for the defined benefit pension plan. The investment policy is in keeping with the fiduciary requirements under existing federal laws and managed in accordance with the Prudent Investor Rule. Total portfolio risk is regularly evaluated and compared to that of the plan’s policy target allocation and judged on a relative basis over a market cycle. The following asset allocation policy and ranges have been established in accordance with the overall risk and return objectives of the portfolio:


	As of 12/31/13			Permitted Range
Total Equity		23	%		10-30	%
Total Fixed Income		74	%		70-90	%
Other		3	%		0-10	%

In accordance with the investment policy, the portfolio will invest in high quality, large and small capitalization companies traded on national exchanges, and investment grade securities. The investment managers will not write or buy options for speculative purposes; securities may not be margined or sold short. The manager may employ futures or options for the purpose of hedging exposure, and will not purchase unregistered sectors, private placements, partnerships or commodities.

Segment Reporting

12 Months Ended

Dec. 31, 2013

Segment Reporting

11) 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 information services, purchasing, reimbursement, accounting, taxation, legal, advertising, design and construction and patient accounting as well as the operating results for our other operating entities including outpatient surgery and radiation centers. The chief operating decision making group for our acute care hospital 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 this Annual Report on Form 10-K for the year ended December 31, 2013. 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, with the non-directly allocated overhead expenses allocated based upon each segment’s respective percentage of total facility-based operating expenses.


2013	Acute Care Hospital Services			Behavioral Health Services			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	13,469,269		$	6,294,046			—		$	19,763,315
Gross outpatient revenues	$	6,828,307		$	744,510		$	40,460		$	7,613,277
Total net revenues	$	3,576,369		$	3,667,967		$	39,486		$	7,283,822
Income (loss) before allocation of corporate overhead and income taxes	$	342,191		$	895,869		($	368,728	)	$	869,332
Allocation of corporate overhead	($	184,444	)	($	89,447	)	$	273,891		$	0
Income (loss) after allocation of corporate overhead and before income taxes	$	157,747		$	806,422		($	94,837	)	$	869,332
Total assets	$	3,125,626		$	4,966,182		$	219,915		$	8,311,723


2012	Acute Care Hospital Services			Behavioral Health Services			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	12,406,567		$	5,764,370			—		$	18,170,937
Gross outpatient revenues	$	6,134,615		$	646,177		$	48,183		$	6,828,975
Total net revenues	$	3,461,416		$	3,460,141		$	39,843		$	6,961,400
Income (loss) before allocation of corporate overhead and income taxes	$	337,385		$	838,603		($	412,325	)	$	763,663
Allocation of corporate overhead	($	162,056	)	($	84,597	)	$	246,653		$	0
Income (loss) after allocation of corporate overhead and before income taxes	$	175,329		$	754,006		($	165,672	)	$	763,663
Total assets	$	2,984,169		$	4,979,965		$	236,709		$	8,200,843


2011	Acute Care Hospital Services			Behavioral Health Services			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	11,770,248		$	5,507,728			—		$	17,277,976
Gross outpatient revenues	$	5,431,146		$	606,876		$	53,240		$	6,091,262
Total net revenues	$	3,423,957		$	3,308,862		$	27,403		$	6,760,222
Income (loss) before allocation of corporate overhead and income taxes	$	352,931		$	729,142		($	385,737	)	$	696,336
Allocation of corporate overhead	($	131,225	)	($	62,710	)	$	193,935		$	0
Income (loss) after allocation of corporate overhead and before income taxes	$	221,706		$	666,432		($	191,802	)	$	696,336
Total assets	$	2,782,102		$	4,373,379		$	509,764		$	7,665,245

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

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+ Details

Quarterly Results

12 Months Ended

Dec. 31, 2013

Quarterly Results

12) QUARTERLY RESULTS (unaudited)

The following tables summarize the quarterly financial data for the two years ended December 31, 2013 and 2012:


2013	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Net revenues	$	1,831,632	$	1,834,975	$	1,816,369	$	1,800,846	$	7,283,822
Net income	$	129,935	$	167,803	$	123,099	$	133,186	$	554,023
Less: Net income attributable to noncontrolling interests	$	10,151	$	15,962	$	8,512	$	8,665	$	43,290

Net income attributable to UHS	$	119,784	$	151,841	$	114,587	$	124,521	$	510,733

Earnings per share attributable to UHS-Basic:

Total basic earnings per share	$	1.23	$	1.55	$	1.17	$	1.27	$	5.21

Earnings per share attributable to UHS-Diluted:

Total diluted earnings per share	$	1.21	$	1.53	$	1.15	$	1.24	$	5.14

The 2013 quarterly financial data presented above includes the following:

First Quarter:

•

an unfavorable $1.1 million pre-tax impact ($327,000, or $.01 per diluted share, net of taxes) recorded in connection with the implementation of EHR applications.

Second Quarter:

•

an unfavorable $8.9 million pre-tax impact ($4.9 million, or $.05 per diluted share, net of taxes) recorded in connection with the implementation of EHR applications;

•

a favorable $65.0 million pre-tax impact reduction ($37.8 million, or $.38 per diluted share, net of taxes) to our professional and general liability self-insurance reserves relating to years prior to 2013, as discussed in Self-Insured Risks.

Third Quarter:

•

a favorable $8.4 million pre-tax impact ($5.1 million, or $.05 per diluted share, net of taxes) recorded in connection with the implementation of EHR applications.

Fourth Quarter:

•

a favorable $19.4 million pre-tax impact ($11.8 million, or $.12 per diluted share, net of taxes) recorded in connection with the implementation of EHR applications;

•

a favorable $15.6 million pre-tax impact reduction ($9.2 million, or $.09 per diluted share, net of taxes) to our professional and general liability self-insurance reserves relating to years prior to 2013, as discussed in Self-Insured Risks.


2012	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Net revenues	$	1,793,036	$	1,723,084	$	1,680,353	$	1,764,927	$	6,961,400
Net income	$	142,570	$	117,444	$	81,373	$	147,660	$	489,047
Less: Net income attributable to noncontrolling interests	$	13,963	$	9,883	$	9,556	$	12,199	$	45,601

Net income attributable to UHS	$	128,607	$	107,561	$	71,817	$	135,461	$	443,446

Earnings per share attributable to UHS-Basic:

Total basic earnings per share	$	1.33	$	1.11	$	0.74	$	1.39	$	4.57

Earnings per share attributable to UHS-Diluted:

Total diluted earnings per share	$	1.31	$	1.10	$	0.73	$	1.39	$	4.53

The 2012 quarterly financial data presented above includes the following:

First Quarter:

•

a favorable $30.2 million pre-tax impact ($18.8 million, or $.19 per diluted share, net of taxes) resulting from an agreement entered into with the United States Department of Health and Human Services, the Secretary of Health and Human Services, and the Centers for Medicare and Medicaid Services (referred to collectively as “HHS”). This agreement, which was part of an industry-wide settlement with HHS related to litigation that was pending for several years contending that acute care hospitals in the U.S. were underpaid from the Medicare inpatient prospective payment system during a number of prior years;

•

a favorable $7.0 million pre-tax impact ($4.3 million, or $.04 per diluted share, net of taxes) representing the 2011 portion of the net Medicaid supplemental reimbursements we expect to receive pursuant to the Oklahoma Supplemental Hospital Offset Payment Program;

•

an aggregate unfavorable $8.3 million pre-tax impact ($5.1 million, or $.05 per diluted share, net of taxes) resulting from: (i) the revised Supplemental Security Income ratios utilized for calculating Medicare disproportionate share hospital reimbursements for federal fiscal years 2006 through 2009 ($2.4 million unfavorable after-tax impact), and; (ii) the write-off of receivables related to revenues recorded during 2011 at two of our acute care hospitals located in Florida resulting from reductions in certain county reimbursements due to reductions in federal matching Inter-Governmental Transfer funds ($2.7 million unfavorable after-tax impact).

Second Quarter:

•

an unfavorable $8.0 million pre-tax impact ($5.0 million, or $.05 per diluted share, net of taxes) recorded in connection with the implementation of EHR applications;

•

a favorable $5.5 million pre-tax impact ($3.4 million, or $.03 per diluted share, net of taxes) representing net Medicaid reimbursements related to prior years.

Third Quarter:

•

a favorable $2.2 million pre-tax impact ($1.3 million, or $.01 per diluted share, net of taxes) recorded in connection with the implementation of EHR applications;

•

an unfavorable $29.2 million pre-tax impact ($18.1 million, or $0.19 per diluted share, net of taxes) resulting from the write-off of deferred financing costs related to the portion of our Term Loan B credit facility that was extinguished during the third quarter of 2012.

Fourth Quarter:

•

a favorable $26.4 million pre-tax impact ($16.4 million, or $0.17 per diluted share, net of taxes) gain resulting from the sale of an acute care facility located in Auburn, Washington;

•

a favorable $8.9 million pre-tax impact ($5.5 million, or $.06 per diluted share, net of taxes) recorded in connection with the implementation of EHR applications;

•

a favorable $27.2 million pre-tax impact reduction ($15.5 million, or $.16 per diluted share, net of taxes) to our professional and general liability self-insurance reserves relating to years prior to 2012, as discussed in Self-Insured Risks.

- Definition

The entire disclosure for the quarterly financial data in the annual financial statements. The disclosure may include a tabular presentation of financial information for each fiscal quarter for the current and previous year, including revenues, gross profit, income or loss before extraordinary items and earnings per share data. It also includes an indication if the information in the note is unaudited, comments on the aggregate effect of year-end adjustments, and an explanation of matters or transactions that affect comparability or are pertinent to an understanding of the information furnished.

+ References+ Details

Supplemental Condensed Consolidating Financial Information

12 Months Ended

Dec. 31, 2013

Supplemental Condensed Consolidating Financial Information

13) SUPPLEMENTAL CONDENSED CONSOLIDATING FINANCIAL INFORMATION

Certain of our senior notes are guaranteed by a group of subsidiaries (the “Guarantors”). The Guarantors, each of which is a 100% directly owned subsidiary of Universal Health Services, Inc., fully and unconditionally guarantee the senior notes on a joint and several basis, subject to certain customary release provisions.

The following financial statements present condensed consolidating financial data for (i) Universal Health Services, Inc. (on a parent company only basis), (ii) the combined Guarantors, (iii) the combined non guarantor subsidiaries (all other subsidiaries), (iv) an elimination column for adjustments to arrive at the information for the parent company, Guarantors, and non guarantors on a consolidated basis, and (v) the parent company and our subsidiaries on a consolidated basis.

Investments in subsidiaries are accounted for by the parent company and the Guarantors using the equity method for this presentation. Results of operations of subsidiaries are therefore classified in the parent company’s and Guarantors’ investment in subsidiaries accounts. The elimination entries set forth in the following condensed consolidating financial statements eliminate distributed and undistributed income of subsidiaries, investments in subsidiaries, and intercompany balances and transactions between the parent, Guarantors, and non guarantors.

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2013

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net revenues before provision for doubtful accounts	$	0		$	5,658,699		$	2,780,983		$	(28,644	)	$	8,411,038
Less: Provision for doubtful accounts		0			657,106			470,110			0			1,127,216

Net Revenues		0			5,001,593			2,310,873			(28,644	)		7,283,822
Operating charges:
Salaries, wages and benefits		0			2,573,205			1,031,415			0			3,604,620
Other operating expenses		0			972,170			523,382			(26,808	)		1,468,744
Supplies expense		0			510,078			311,011			0			821,089
Depreciation and amortization		0			236,958			100,214			0			337,172
Lease and rental expense		0			62,518			37,076			(1,836	)		97,758
EHR incentive income		0			(43,027	)		(17,997	)		0			(61,024	)

		0			4,311,902			1,985,101			(28,644	)		6,268,359

Income from operations		0			689,691			325,772			0			1,015,463
Interest expense		139,793			3,365			2,973			0			146,131
Interest (income) expense, affiliate		0			84,640			(84,640	)		0			0
Equity in net income of consolidated affiliates		(597,020	)		(141,004	)		0			738,024			0

Income before income taxes		457,227			742,690			407,439			(738,024	)		869,332
Provision for income taxes		(53,506	)		262,346			106,469			0			315,309

Net income		510,733			480,344			300,970			(738,024	)		554,023
Less: Income attributable to noncontrolling interests		0			0			43,290			0			43,290

Net income attributable to UHS	$	510,733		$	480,344		$	257,680		$	(738,024	)	$	510,733

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2012

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net revenues before provision for doubtful accounts	$	0		$	5,152,816		$	2,562,781		$	(27,526	)	$	7,688,071
Less: Provision for doubtful accounts		0			411,538			315,133			0			726,671

Net Revenues		0			4,741,278			2,247,648			(27,526	)		6,961,400
Operating charges:
Salaries, wages and benefits		0			2,452,187			988,730			0			3,440,917
Other operating expenses		0			899,274			502,592			(25,744	)		1,376,122
Supplies expense		0			496,848			302,773			0			799,621
Depreciation and amortization		0			210,867			91,559			0			302,426
Lease and rental expense		0			59,596			37,071			(1,782	)		94,885
Transaction costs		0			5,716			0			0			5,716
EHR incentive income		0			(14,284	)		(15,754	)		0			(30,038	)
Costs related to extinguishment of debt		29,170			0			0			0			29,170

		29,170			4,110,204			1,906,971			(27,526	)		6,018,819

Income from operations		(29,170	)		631,074			340,677			0			942,581
Interest expense		172,467			3,749			2,702			0			178,918
Interest (income) expense, affiliate		0			93,363			(93,363	)		0			0
Equity in net income of consolidated affiliates		(567,906	)		(141,983	)		0			709,889			0

Income before income taxes		366,269			675,945			431,338			(709,889	)		763,663
Provision for income taxes		(77,177	)		237,072			114,721			0			274,616

Net income		443,446			438,873			316,617			(709,889	)		489,047
Less: Income attributable to noncontrolling interests		0			0			45,601			0			45,601

Net income attributable to UHS	$	443,446		$	438,873		$	271,016		$	(709,889	)	$	443,446

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2011

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net revenues before provision for doubtful accounts	$	0		$	4,917,358		$	2,465,916		$	(26,476	)	$	7,356,798
Less: Provision for doubtful accounts		0			340,121			256,455			0			596,576

Net revenues		0			4,577,237			2,209,461			(26,476	)		6,760,222
Operating charges:
Salaries, wages and benefits		0			2,371,961			954,417			0			3,326,378
Other operating expenses		200			923,579			454,601			(24,687	)		1,353,693
Supplies expense		0			499,200			306,289			0			805,489
Depreciation and amortization		0			207,981			79,230			0			287,211
Lease and rental expense		0			60,768			31,344			(1,789	)		90,323

		200			4,063,489			1,825,881			(26,476	)		5,863,094

Income from operations		(200	)		513,748			383,580			0			897,128
Interest expense		195,404			3,212			2,176			0			200,792
Interest (income) expense, affiliate		0			87,205			(87,205	)		0			0
Equity in net income of consolidated affiliates		(518,797	)		(157,009	)		0			675,806			0

Income before income taxes		323,193			580,340			468,609			(675,806	)		696,336
Provision for income taxes		(74,974	)		198,091			124,349			0			247,466

Net income		398,167			382,249			344,260			(675,806	)		448,870
Less: Income attributable to noncontrolling interests		0			0			50,703			0			50,703

Net income attributable to UHS	$	398,167		$	382,249		$	293,557		$	(675,806	)	$	398,167

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2013

(amounts in thousands)


	Parent			Guarantors		Non Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Net income	$	510,733		$	480,344	$	300,970	$	(738,024	)	$	554,023
Other comprehensive income (loss):
Unrealized derivative gains on cash flow hedges		16,963			0		0		0			16,963
Amortization of terminated hedge		(336	)		0		0		0			(336	)
Minimum Pension Liability		14,657			14,657		0		(14,657	)		14,657

Other comprehensive income before tax		31,284			14,657		0		(14,657	)		31,284
Income tax expense related to items of other comprehensive income		11,940			5,670		0		(5,670	)		11,940

Total other comprehensive income, net of tax		19,344			8,987		0		(8,987	)		19,344

Comprehensive income		530,077			489,331		300,970		(747,011	)		573,367
Less: Comprehensive income attributable to noncontrolling interests		0			0		43,290		0			43,290

Comprehensive income attributable to UHS	$	530,077		$	489,331	$	257,680	$	(747,011	)	$	530,077

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2012

(amounts in thousands)


	Parent			Guarantors		Non Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Net income	$	443,446		$	438,873	$	316,617	$	(709,889	)	$	489,047
Other comprehensive income (loss):
Unrealized derivative gains on cash flow hedges		6,677			0		0		0			6,677
Amortization of terminated hedge		(336	)		0		0		0			(336	)
Minimum Pension Liability		4,986			4,986		0		(4,986	)		4,986

Other comprehensive income before tax		11,327			4,986		0		(4,986	)		11,327
Income tax expense related to items of other comprehensive income		4,306			1,898		0		(1,898	)		4,306

Total other comprehensive income, net of tax		7,021			3,088		0		(3,088	)		7,021

Comprehensive income		450,467			441,961		316,617		(712,977	)		496,068
Less: Comprehensive income attributable to noncontrolling interests		0			0		45,601		0			45,601

Comprehensive income attributable to UHS	$	450,467		$	441,961	$	271,016	$	(712,977	)	$	450,467


UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME
FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2011 (amounts in thousands)
	Parent			Guarantors			Non Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Net income	$	398,167		$	382,249		$	344,260	$	(675,806	)	$	448,870
Other comprehensive income (loss):
Unrealized derivative gains on cash flow hedges		(37,477	)		0			0		0			(37,477	)
Amortization of terminated hedge		(336	)		0			0		0			(336	)
Minimum Pension Liability		(12,397	)		(12,397	)		0		12,397			(12,397	)

Other comprehensive income before tax		(50,210	)		(12,397	)		0		12,397			(50,210	)
Income tax expense related to items of other comprehensive income		(19,174	)		(4,691	)		0		4,691			(19,174	)

Total other comprehensive income, net of tax		(31,036	)		(7,706	)		0		7,706			(31,036	)

Comprehensive income		367,131			374,543			344,260		(668,100	)		417,834
Less: Comprehensive income attributable to noncontrolling interests		0			0			50,703		0			50,703

Comprehensive income attributable to UHS	$	367,131		$	374,543		$	293,557	$	(668,100	)	$	367,131

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING BALANCE SHEET

AS OF DECEMBER 31, 2013

(amounts in thousands)


	Parent		Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Assets
Current assets:
Cash and cash equivalents	$	0	$	7,990		$	9,248		$	0		$	17,238
Accounts receivable, net		0		799,898			317,063			0			1,116,961
Supplies		0		63,562			38,219			0			101,781
Deferred income taxes		76,719		43,184			0			0			119,903
Other current assets		0		63,786			12,660			0			76,446

Total current assets		76,719		978,420			377,190			0			1,432,329

Investments in subsidiaries		6,378,499		1,476,911			0			(7,855,410	)		0
Intercompany receivable		226,592		0			531,411			(758,003	)		0
Intercompany note receivable		0		0			982,568			(982,568	)		0
Property and equipment		0		4,093,914			1,597,988			0			5,691,902
Less: accumulated depreciation		0		(1,478,758	)		(770,975	)		0			(2,249,733	)

		0		2,615,156			827,013			0			3,442,169

Other assets:
Goodwill		0		2,552,190			496,826			0			3,049,016
Deferred charges		49,866		5,577			2,438			0			57,881
Other		8,411		251,365			70,552			0			330,328

	$	6,740,087	$	7,879,619		$	3,287,998		$	(9,595,981	)	$	8,311,723

Liabilities and Stockholders’ Equity
Current liabilities:
Current maturities of long-term debt	$	97,403		916			993			0		$	99,312
Accounts payable and accrued liabilities		28,099		837,354			87,996			0			953,449
Federal and state taxes		4,963		2,164			0			0			7,127

Total current liabilities		130,465		840,434			88,989			0			1,059,888

Intercompany payable		0		758,003			0			(758,003	)		0
Other noncurrent liabilities		7,591		199,104			77,894			0			284,589
Long-term debt		3,168,819		5,337			35,606			0			3,209,762
Intercompany note payable		0		982,568			0			(982,568	)		0
Deferred income taxes		183,233		55,915			0			0			239,148
Redeemable noncontrolling interests		0		0			218,107			0			218,107
UHS common stockholders’ equity		3,249,979		5,038,258			2,817,152			(7,855,410	)		3,249,979
Noncontrolling interest		0		0			50,250			0			50,250

Total equity		3,249,979		5,038,258			2,867,402			(7,855,410	)		3,300,229

	$	6,740,087	$	7,879,619		$	3,287,998		$	(9,595,981	)	$	8,311,723

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING BALANCE SHEET

AS OF DECEMBER 31, 2012

(amounts in thousands)


	Parent		Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
	Parent		Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Assets
Current assets:
Cash and cash equivalents	$	0	$	11,949		$	11,522		$	0		$	23,471
Accounts receivable, net		7,154		741,983			318,060			0			1,067,197
Supplies		0		61,100			37,900			0			99,000
Deferred income taxes		61,364		43,555			322			(780	)		104,461
Other current assets		2,188		75,117			10,631			0			87,936
Current assets held for sale		0		0			25,431			0			25,431

Total current assets		70,706		933,704			403,866			(780	)		1,407,496

Investments in subsidiaries		5,781,479		1,326,920			0			(7,108,399	)		0
Intercompany receivable		644,105		0			360,538			(1,004,643	)		0
Intercompany note receivable		0		0			1,007,453			(1,007,453	)		0
Property and equipment		0		3,867,471			1,500,874			0			5,368,345
Less: accumulated depreciation		0		(1,288,975	)		(697,135	)		0			(1,986,110	)

		0		2,578,496			803,739			0			3,382,235

Other assets:
Goodwill		820		2,554,531			481,414			0			3,036,765
Deferred charges		67,831		5,839			2,218			0			75,888
Other		9,645		209,558			79,256			0			298,459

	$	6,574,586	$	7,609,048		$	3,138,484		$	(9,121,275	)	$	8,200,843

Liabilities and Stockholders’ Equity
Current liabilities:
Current maturities of long-term debt	$	0		990			1,599			0		$	2,589
Accounts payable and accrued liabilities		10,985		740,484			138,088			0			889,557
Current liabilities held for sale		0		0			850			0			850
Federal and state taxes		0		900			620			(458	)		1,062

Total current liabilities		10,985		742,374			141,157			(458	)		894,058

Intercompany payable		0		1,004,643			0			(1,004,643	)		0
Other noncurrent liabilities		46,048		243,478			105,829			0			395,355
Long-term debt		3,676,940		5,372			45,119			0			3,727,431
Intercompany note payable		0		1,007,453			0			(1,007,453	)		0
Deferred income taxes		127,268		56,801			0			(322	)		183,747
Redeemable noncontrolling interests		0		0			234,303			0			234,303
UHS common stockholders’ equity		2,713,345		4,548,927			2,559,472			(7,108,399	)		2,713,345
Noncontrolling interest		0		0			52,604			0			52,604

Total equity		2,713,345		4,548,927			2,612,076			(7,108,399	)		2,765,949

	$	6,574,586	$	7,609,048		$	3,138,484		$	(9,121,275	)	$	8,200,843

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2013

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments		Total Consolidated Amounts
Net cash provided by operating activities	$	17,946		$	587,083		$	279,212		$	0	$	884,241

Cash Flows from Investing Activities:
Property and equipment additions, net of disposals		0			(269,419	)		(89,074	)		0		(358,493	)
Acquisition of property and businesses		0			(8,094	)		(4,542	)		0		(12,636	)
Proceeds received from sale of assets and businesses		0			7,916			29,566			0		37,482
Costs incurred for purchase and development of electronic health records application		0			(49,811	)		0			0		(49,811	)

Net cash used in investing activities		0			(319,408	)		(64,050	)		0		(383,458	)

Cash Flows from Financing Activities:
Reduction of long-term debt		(429,996	)		(109	)		(10,119	)		0		(440,224	)
Additional borrowings		15,761			0			0			0		15,761
Financing costs		(231	)		0			0			0		(231	)
Repurchase of common shares		(27,201	)		0			0			0		(27,201	)
Dividends paid		(19,621	)		0			0			0		(19,621	)
Issuance of common stock		5,708			0			0			0		5,708
Excess income tax benefits related to stock based compensation		20,121			0			0			0		20,121
Profit distributions to noncontrolling interests		0			0			(61,329	)		0		(61,329	)
Changes in intercompany balances with affiliates, net		417,513			(271,525	)		(145,988	)		0		0

Net cash used in financing activities		(17,946	)		(271,634	)		(217,436	)		0		(507,016	)

Decrease in cash and cash equivalents		0			(3,959	)		(2,274	)		0		(6,233	)
Cash and cash equivalents, beginning of period		0			11,949			11,522			0		23,471

Cash and cash equivalents, end of period	$	0		$	7,990		$	9,248		$	0	$	17,238

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2012

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net cash (used in) provided by operating activities	$	(37,648	)	$	594,606		$	242,273		$	0		$	799,231

Cash Flows from Investing Activities:
Property and equipment additions, net of disposals		0			(312,190	)		(51,002	)		0			(363,192	)
Acquisition of property and businesses		0			(513,596	)		(14,251	)		0			(527,847	)
Proceeds received from sale of assets and businesses		0			142,667			6,644			0			149,311
Costs incurred for purchase and development of electronic health records application		0			(54,362	)		0			0			(54,362	)
Return of Deposit on terminated purchase agreement		6,500			0			0			0			6,500

Net cash provided by (used in) investing activities		6,500			(737,481	)		(58,609	)		0			(789,590	)

Cash Flows from Financing Activities:
Reduction of long-term debt		(843,002	)		0			(8,258	)		1,613			(849,647	)
Additional borrowings		913,500			1,613			0			(1,613	)		913,500
Financing costs		(8,283	)		0			0			0			(8,283	)
Repurchase of common shares		(19,154	)		0			0			0			(19,154	)
Dividends paid		(58,395	)		0			0			0			(58,395	)
Issuance of common stock		5,435			0			0			0			5,435
Excess income tax benefits related to stock based compensation		16,040			0			0			0			16,040
Profit distributions to noncontrolling interests		0			0			(26,895	)		0			(26,895	)
Changes in intercompany balances with affiliates, net		25,007			119,990			(144,997	)		0			0

Net cash provided by (used in) financing activities		31,148			121,603			(180,150	)		0			(27,399	)

Increase (decrease) in cash and cash equivalents		0			(21,272	)		3,514			0			(17,758	)
Cash and cash equivalents, beginning of period		0			33,221			8,008			0			41,229

Cash and cash equivalents, end of period	$	0		$	11,949		$	11,522		$	0		$	23,471

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2011

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net cash (used in) provided by operating activities	$	(12,558	)	$	518,462		$	204,779		$	0		$	710,683

Cash Flows from Investing Activities:
Property and equipment additions, net of disposals		0			(226,848	)		(58,834	)		0			(285,682	)
Acquisition of property and businesses		0			0			(29,466	)		0			(29,466	)
Proceeds received from sale of assets and businesses		0			0			67,592			0			67,592
Costs incurred for purchase and development of electronic health records application		0			(38,249	)		0			0			(38,249	)

Net cash used in investing activities		0			(265,097	)		(20,708	)		0			(285,805	)

Cash Flows from Financing Activities:
Reduction of long-term debt		(382,060	)		(1,442	)		0			1,985			(381,517	)
Additional borrowings		98,100			0			1,985			(1,985	)		98,100
Financing costs		(23,608	)		0			0			0			(23,608	)
Repurchase of common shares		(60,482	)		0			0			0			(60,482	)
Dividends paid		(19,466	)		0			0			0			(19,466	)
Issuance of common stock		4,779			0			0			0			4,779
Excess income tax benefits related to stock based compensation		7,568			0			0			0			7,568
Profit distributions to noncontrolling interests		0			0			(38,497	)		0			(38,497	)
Changes in intercompany balances with affiliates, net		387,727			(240,087	)		(147,640	)		0			0

Net cash provided by (used in) financing activities		12,558			(241,529	)		(184,152	)		0			(413,123	)

Increase (decrease) in cash and cash equivalents		0			11,836			(81	)		0			11,755
Cash and cash equivalents, beginning of period		0			21,385			8,089			0			29,474

Cash and cash equivalents, end of period	$	0		$	33,221		$	8,008		$	0		$	41,229

- Definition

The entire disclosure for condensed financial information, including the financial position, cash flows, and the results of operations of the registrant (parent company) as of the same dates or for the same periods for which audited consolidated financial statements are being presented. Alternatively, the details of this disclosure can be reported by the specific parent company taxonomy elements, indicating the appropriate date and period contexts in an instance document.

+ References+ Details

Schedule II-Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2013

Schedule II-Valuation and Qualifying Accounts

SCHEDULE II—VALUATION AND QUALIFYING ACCOUNTS

(amounts in thousands)


Allowance for Doubtful Accounts Receivable:	Balance at beginning of period		Charges to costs and expenses		Acquisitions of business		Write-off of uncollectible accounts			Balance at end of period
Year ended December 31, 2013	$	311,387	$	1,127,216	$	—	$	(1,043,568	)	$	395,035

Year ended December 31, 2012	$	253,405	$	726,671	$	5,632	$	(674,321	)	$	311,387

Year ended December 31, 2011 (a)	$	248,622	$	613,619	$	—	$	(608,836	)	$	253,405

(a)	Included in the charges to costs and expenses in 2011 is $17.0 million related to facilities that were divested or recorded as held for sale during 2012.


Valuation Allowance for Deferred Tax Assets:	Balance at beginning of period		Charges to costs and expenses		Acquisitions of business		Write-off of uncollectible accounts			Balance at end of period
Year ended December 31, 2013	$	44,511	$	2,330	$	—	$	—		$	46,841

Year ended December 31, 2012	$	42,143	$	2,368	$	—	$	—		$	44,511

Year ended December 31, 2011	$	32,352	$	10,904	$	—	$	(1,113	)	$	42,143

Business and Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2013

Principles of Consolidation

Revenue Recognition

Provision for Doubtful Accounts

Concentration of Revenues

Charity Care and Uninsured Discounts

Uncompensated care:


	(dollar amounts in thousands)
	2013					2012					2011
	Amount		%			Amount		%			Amount		%
Charity care	$	593,474		59	%	$	778,268		74	%	$	804,301		84	%
Uninsured discounts		405,296		41	%		267,304		26	%		151,447		16	%

Total uncompensated care	$	998,770		100	%	$	1,045,572		100	%	$	955,748		100	%

In addition, the provision for doubtful accounts at our acute care hospitals were approximately $1.02 billion during 2013, $635 million during 2012 and $519 million during 2011.

The estimated cost of providing uncompensated care:


	(amounts in thousands)
	2013		2012		2011
Estimated cost of providing charity care	$	95,675	$	131,890	$	145,350
Estimated cost of providing uninsured discounts related care		65,338		45,299		27,363

Estimated cost of providing uncompensated care	$	161,013	$	177,189	$	172,713

Accounting for Medicare and Medicaid Electronic Health Records Incentive Payments

Cash and Cash Equivalents

G) Cash and Cash Equivalents: We consider all highly liquid investments purchased with maturities of three months or less to be cash equivalents.

Property and Equipment

Long-Lived Assets

Goodwill and Intangible Assets

Changes in the carrying amount of goodwill for the two years ended December 31, 2013 were as follows (in thousands):


	Acute Care Services			Behavioral Health Services			Total Consolidated
Balance, January 1, 2012	$	389,484		$	2,238,118		$	2,627,602
Goodwill acquired during the period		11,110			434,551			445,661
Goodwill divested during the period		(17,450	)		(1,902	)		(19,352	)
Adjustments to goodwill (a)		(448	)		(16,698	)		(17,146	)

Balance, January 1, 2013		382,696			2,654,069			3,036,765
Adjustments to goodwill (b)		315			11,936			12,251

Balance, December 31, 2013	$	383,011		$	2,666,005		$	3,049,016

(a)

(b)	The increase in the Behavioral Health Services’ goodwill consists primarily of an amount that was reclassified from other assets.

Other Assets

Physician Guarantees and Commitments

Self-Insured Risks

Income Taxes

See Note 6—Income Taxes, for additional disclosure.

Other Noncurrent Liabilities

Redeemable Noncontrolling Interests and Noncontrolling Interest

Comprehensive Income and Accumulated Other Comprehensive Income

The amounts recognized in AOCI for the two years ended December 31, 2013 were as follows (in thousands):


	Net Unrealized Gains (Losses) on Effective Cash Flow Hedges			Minimum Pension Liability			Total AOCI
Balance, January 1, 2012, net of income tax	$	(28,460	)	$	(22,715	)	$	(51,175	)
2012 activity:
Pre-tax amount		6,341			4,986			11,327
Income tax effect		(2,408	)		(1,898	)		(4,306	)

Change, net of income tax		3,933			3,088			7,021

Balance, January 1, 2013, net of income tax		(24,527	)		(19,627	)		(44,154	)
2013 activity:
Pre-tax amount		16,627			14,657			31,284
Income tax effect		(6,270	)		(5,670	)		(11,940	)

Change, net of income tax		10,357			8,987			19,344

Balance, December 31, 2013, net of income tax	$	(14,170	)	$	(10,640	)	$	(24,810	)

Accounting for Derivative Financial Investments and Hedging Activities

Stock-Based Compensation

The expense associated with share-based compensation arrangements is a non-cash charge. In the Consolidated Statements of Cash Flows, share-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities. The applicable FASB guidance requires that cash flows resulting from tax deductions in excess of compensation cost recognized be classified as financing cash flows.

Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share, for the periods indicated:


	Twelve Months Ended December 31,
	2013			2012			2011
Basic and diluted:
Net Income	$	554,023		$	489,047		$	448,870
Less: Net income attributable to noncontrolling interest		(43,290	)		(45,601	)		(50,703	)
Less: Net income attributable to unvested restricted share grants		(294	)		(497	)		(521	)

Net income attributable to UHS—basic and diluted	$	510,439		$	442,949		$	397,646

Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		98,033			96,821			97,199

Total basic earnings per share	$	5.21		$	4.57		$	4.09

Diluted earnings per share attributable to UHS:
Weighted average number of common shares		98,033			96,821			97,199
Net effect of dilutive stock options and grants based on the treasury stock method		1,328			890			1,338

Weighted average number of common shares and equivalents—diluted		99,361			97,711			98,537

Total diluted earnings per share	$	5.14		$	4.53		$	4.04

Fair Value of Financial Instruments

Use of Estimates

Mergers and Acquisitions

GPO Agreement/Minority Ownership Interest

Accounting Standards

Y) Accounting Standards:

Business and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2013

Uncompensated Care


	(dollar amounts in thousands)
	2013					2012					2011
	Amount		%			Amount		%			Amount		%
Charity care	$	593,474		59	%	$	778,268		74	%	$	804,301		84	%
Uninsured discounts		405,296		41	%		267,304		26	%		151,447		16	%

Total uncompensated care	$	998,770		100	%	$	1,045,572		100	%	$	955,748		100	%

Estimated Cost of Providing Uncompensated Care


	(amounts in thousands)
	2013		2012		2011
Estimated cost of providing charity care	$	95,675	$	131,890	$	145,350
Estimated cost of providing uninsured discounts related care		65,338		45,299		27,363

Estimated cost of providing uncompensated care	$	161,013	$	177,189	$	172,713

Changes in Carrying Amount of Goodwill

Changes in the carrying amount of goodwill for the two years ended December 31, 2013 were as follows (in thousands):


	Acute Care Services			Behavioral Health Services			Total Consolidated
Balance, January 1, 2012	$	389,484		$	2,238,118		$	2,627,602
Goodwill acquired during the period		11,110			434,551			445,661
Goodwill divested during the period		(17,450	)		(1,902	)		(19,352	)
Adjustments to goodwill (a)		(448	)		(16,698	)		(17,146	)

Balance, January 1, 2013		382,696			2,654,069			3,036,765
Adjustments to goodwill (b)		315			11,936			12,251

Balance, December 31, 2013	$	383,011		$	2,666,005		$	3,049,016

(a)

(b)	The increase in the Behavioral Health Services’ goodwill consists primarily of an amount that was reclassified from other assets.

Amounts Recognized in AOCI

The amounts recognized in AOCI for the two years ended December 31, 2013 were as follows (in thousands):


	Net Unrealized Gains (Losses) on Effective Cash Flow Hedges			Minimum Pension Liability			Total AOCI
Balance, January 1, 2012, net of income tax	$	(28,460	)	$	(22,715	)	$	(51,175	)
2012 activity:
Pre-tax amount		6,341			4,986			11,327
Income tax effect		(2,408	)		(1,898	)		(4,306	)

Change, net of income tax		3,933			3,088			7,021

Balance, January 1, 2013, net of income tax		(24,527	)		(19,627	)		(44,154	)
2013 activity:
Pre-tax amount		16,627			14,657			31,284
Income tax effect		(6,270	)		(5,670	)		(11,940	)

Change, net of income tax		10,357			8,987			19,344

Balance, December 31, 2013, net of income tax	$	(14,170	)	$	(10,640	)	$	(24,810	)

Computation of Basic and Diluted Earnings Per Share

The following table sets forth the computation of basic and diluted earnings per share, for the periods indicated:


	Twelve Months Ended December 31,
	2013			2012			2011
Basic and diluted:
Net Income	$	554,023		$	489,047		$	448,870
Less: Net income attributable to noncontrolling interest		(43,290	)		(45,601	)		(50,703	)
Less: Net income attributable to unvested restricted share grants		(294	)		(497	)		(521	)

Net income attributable to UHS—basic and diluted	$	510,439		$	442,949		$	397,646

Basic earnings per share attributable to UHS:
Weighted average number of common shares—basic		98,033			96,821			97,199

Total basic earnings per share	$	5.21		$	4.57		$	4.09

Diluted earnings per share attributable to UHS:
Weighted average number of common shares		98,033			96,821			97,199
Net effect of dilutive stock options and grants based on the treasury stock method		1,328			890			1,338

Weighted average number of common shares and equivalents—diluted		99,361			97,711			98,537

Total diluted earnings per share	$	5.14		$	4.53		$	4.04

Acquisitions and Divestitures (Tables)

12 Months Ended

Dec. 31, 2013

Results of Operations for Former PSI Facilities Reflected as Discontinued Operations


	2013			2012			2011
Net revenues	$	7,813		$	95,226		$	159,218
Income (loss) from discontinued operations, before income taxes		932			(3,472	)		10,422
Gain on divestiture		3,080			26,419			442

Income from discontinued operations, before income tax expense		4,012			22,947			10,864
Income tax expense		(1,506	)		(8,688	)		(4,113	)

Income from discontinued operations, net of income taxes	$	2,506		$	14,259		$	6,751

2012 Acquisitions of Assets and Businesses

Net Purchase Price Allocation to Assets and Liabilities based on their Estimated Fair Value

The aggregate net cash expenditure related to the properties and/or businesses was allocated to assets and liabilities based on their estimated fair values as follows:


	Amount (000s)
Property, plant & equipment	$	35,000
Other assets/deposits		11,000
Debt		(17,000	)

Cash paid in 2011 for acquisitions and deposits	$	29,000

2011 Acquisitions of Assets and Businesses

Net Purchase Price Allocation to Assets and Liabilities based on their Estimated Fair Value

The aggregate net purchase price of the facilities was allocated to assets and liabilities based on their estimated fair values as follows:


	Amount (000s)
Working capital, net	$	21,000
Property & equipment		60,000
Goodwill		446,000
Other assets		9,000
Income tax assets, net of deferred tax liabilities		(1,000	)
Other liabilities		(7,000	)

Cash paid in 2012 for acquisitions	$	528,000

- Definition

Tabular disclosure of disposal groups, which may include the gain (loss) recognized in the income statement and the income statement caption that includes that gain (loss), amounts of revenues and pretax profit or loss reported in discontinued operations, the classification and carrying value of the assets and liabilities comprising the disposal group, and the segment in which the disposal group was reported. Also may include the amount of adjustments to amounts previously reported in discontinued operations such as resolution of contingencies arising from the disposal transaction or the operations of the component prior to disposal.

+ References+ Details

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2013

Summary of Long-Term Debt

A summary of long-term debt follows:


	December 31,
	2013			2012
	(amounts in thousands)
Long-term debt:
Notes payable and Mortgages payable (including obligations under capitalized leases of $6,633 in 2013 and $8,267 in 2012) and term loans with varying maturities through 2037; weighted average interest rates of 5.9% in each of 2013 and 2012 (see Note 7 regarding capitalized leases)	$	37,553		$	47,216
Revolving credit and on-demand credit facility		25,500			163,500
Term Loan A, net of unamortized discount of $3,340 in 2013 and $4,612 in 2012		935,308			983,438
Term Loan B, net of unamortized discount of $6,473 in 2013 and $8,724 in 2012		543,527			737,176
Term Loan A2		871,875			894,375
Revenue bonds, interest at floating rates of 0.1% at December 31, 2013 and 0.2% at December 31, 2012, with varying maturities through 2015		5,300			5,300
Accounts receivable securitization program		240,000			249,000
7.125% Senior Secured Notes due 2016, including unamortized net premium of $11 in 2013 and $15 in 2012		400,011			400,015
7.00% Senior Unsecured Notes due 2018		250,000			250,000

		3,309,074			3,730,020
Less-Amounts due within one year		(99,312	)		(2,589	)

	$	3,209,762		$	3,727,431

Aggregate Maturities

Aggregate maturities follow:


	(000s)
2014	$	99,312
2015		139,261
2016		2,804,569
2017		1,798
2018		251,893
Later		12,241

Total	$	3,309,074

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 235

-SubTopic 10

-Section S99

-Paragraph 1

-Subparagraph (SX 210.4-08.(e),(f))

-URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690

Reference 2: http://www.xbrl.org/2003/role/presentationRef

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-Name Accounting Standards Codification

-Topic 835

-SubTopic 30

-Section 55

-Paragraph 8

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-SubTopic 30

-Section 45

-Paragraph 2

-URI http://asc.fasb.org/extlink&oid=6451184&loc=d3e28551-108399

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-Topic 835

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Reference 6: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 02

-Paragraph 22

-Article 5

Reference 7: http://www.xbrl.org/2003/role/presentationRef

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-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section S99

-Paragraph 1

-Subparagraph (SX 210.5-02.22)

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-URI http://asc.fasb.org/extlink&oid=6479336&loc=d3e64711-112823

+ Details

Common Stock (Tables)

12 Months Ended

Dec. 31, 2013


	Total number of shares purchased as part of publicly announced programs		Total price paid for shares purchased as part of publicly announced programs (in thousands)		Total number of shares purchased related to stock-based compensation plans (a.)		Total price paid for shares purchased related to stock-based compensation plans (in thousands)		Aggregate number of shares purchased		Aggregate price paid for shares purchased (in thousands)		Maximum number of shares that may yet be purchased under the publicly announced program
Balance as of January 1, 2011														2,152,339
2011		1,384,637	$	50,576		217,649	$	9,906		1,602,286	$	60,482		767,702
2012		—		—		433,312	$	19,154		433,312	$	19,154		767,702
2013		—		—		427,170	$	27,201		427,170	$	27,201		767,702

Total for three year period ended December 31, 2013		1,384,637	$	50,576		1,078,131	$	56,261		2,462,768	$	106,837

(a.)

Weighted-Average Assumptions Fair Value of Option Grants

The weighted-average assumptions reflected below were each based upon eighteen option grants.


Year Ended December 31,	2013			2012			2011
Volatility		36	%		33	%		29	%
Interest rate		1	%		1	%		2	%
Expected life (years)		3.6			3.5			3.5
Forfeiture rate		11	%		10	%		9	%
Dividend yield		0.5	%		0.6	%		0.7	%

Stock Option Activity

The table below summarizes our stock option activity during each of the last three years:


Outstanding Options	Number of Shares			Average Option Price		Range (High-Low)
Balance, January 1, 2011		6,594,950		$	25.16	$	32.28 -$16.22
Granted		2,894,500		$	43.66	$	54.79 -$38.12
Exercised		(1,563,255	)	$	26.38	$	32.28 -$16.22
Cancelled		(367,250	)	$	32.60	$	46.97 -$16.22

Balance, January 1, 2012		7,558,945		$	31.63	$	54.79 -$16.22
Granted		2,966,850		$	37.01	$	44.83 -$36.95
Exercised		(2,608,007	)	$	23.22	$	46.97 -$16.22
Cancelled		(481,550	)	$	38.00	$	46.97 -$16.22

Balance, January 1, 2013		7,436,238		$	36.31	$	54.79 -$16.22
Granted		2,889,750		$	53.51	$	79.79 -$53.38
Exercised		(2,288,666	)	$	32.27	$	54.79 -$16.22
Cancelled		(416,364	)	$	43.93	$	53.38 -$16.22

Balance, December 31, 2013		7,620,958		$	43.63	$	79.79 -$30.32

Outstanding options vested and exercisable as of December 31, 2013		1,756,128		$	35.60	$	46.97 -$30.32

Information about Unvested Options

The following table provides information about unvested options for the year December 31, 2013:


	Shares			Weighted Average Grant Date Fair Value
Unvested options as of January 1, 2013		5,250,926		$	10.74
Granted		2,889,750		$	13.33
Vested		(1,864,982	)	$	10.22
Cancelled		(410,864	)	$	11.66

Unvested options as of December 31, 2013		5,864,830		$	12.12

Information about all Outstanding Options and Exercisable Options

The following table provides information about all outstanding options, and exercisable options, at December 31, 2013:


	Options Outstanding		Options Exercisable
Number		7,620,958		1,756,128
Weighted average exercise price	$	43.64	$	35.60
Aggregate intrinsic value as of December 31, 2013	$	286,740,433	$	80,189,277
Weighted average remaining contractual life		2.9		1.6

Weighted Average Remaining Contractual Life for Options Outstanding and Weighted Average Exercise Price Per Share for Exercisable Options

The weighted average remaining contractual life for options outstanding and weighted average exercise price per share for exercisable options at December 31, 2013 were as follows:


	Options Outstanding		Exercisable Options		Expected to Vest Options (a)
Exercise Price	Shares		Weighted Average Exercise Price Per Share		Weighted Average Remaining Contractual Life (in Years)		Shares		Weighted Average Exercise Price Per Share		Shares		Weighted Average Exercise Price Per Share
$30.32 – $36.95		3,183,583	$	35.14		2.4		1,259,453	$	32.45		1,716,901	$	36.91
$38.12 – $43.67		1,685,350		43.56		2.1		496,175		43.58		1,061,101		43.55
$44.83 – $53.38		2,724,525		53.36		4.0		500		46.97		2,430,648		53.36
$54.79 – $79.79		27,500		67.64		4.0		0		N/A		24,538		67.64

Total		7,620,958	$	43.63		2.9		1,756,128	$	35.60		5,233,188	$	46.04

(a)	Assumes a weighted average forfeiture rate of 10.8%.

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2013

Components of Income Tax Expense (Benefit)

Components of income tax expense/(benefit) are as follows (amounts in thousands):


	Year Ended December 31,
	2013		2012			2011
Current
Federal	$	256,545	$	254,021		$	165,409
Foreign		1,655		9,084			300
State		28,490		39,076			22,901

		286,690		302,181			188,610
Deferred
Federal and foreign		25,341		(21,408	)		53,056
State		3,278		(6,157	)		5,800

		28,619		(27,565	)		58,856

Total	$	315,309	$	274,616		$	247,466

Components of Deferred Taxes

The components of deferred taxes are as follows (amounts in thousands):


	Year Ended December 31,
	2013			2012
Deferred income tax assets:
Self-insurance reserves	$	87,483		$	112,587
Compensation accruals		49,302			47,571
State and foreign net operating loss carryforwards and other state and foreign deferred tax assets		57,204			54,874
Other currently non-deductible accrued liabilities		24,587			29,934
Net pension liability—OCI only		6,390			12,061
Doubtful accounts and other reserves		33,905			17,562
Other combined items—OCI only		9,018			15,282

		267,889			289,871
Less: Valuation Allowance		(46,841	)		(44,511	)

Net deferred income tax assets:		221,048			245,360
Deferred income tax liabilities:
Depreciable and amortizable assets		(337,669	)		(322,317	)
Other deferred tax liabilities		(2,624	)		(2,329	)

Net deferred income tax liabilities	$	(119,245	)	$	(79,286	)

Effective Tax Rates Calculation


	2013			2012			2011
Provision for income taxes	$	315,309		$	274,616		$	247,466
Income before income taxes		869,332			763,663			696,336

Effective tax rate		36.3	%		36.0	%		35.5	%

Reconciliation Between Federal Statutory Rate and Effective Tax Rate

A reconciliation between the federal statutory rate and the effective tax rate is as follows:


	Year Ended December 31,
	2013			2012			2011
Federal statutory rate		35.0	%		35.0	%		35.0	%
State taxes, net of federal income tax benefit		2.5			3.0			2.9
Nondeductible transaction costs		—			0.2			—
Divestiture Gain		0.3			—			—
Other items		0.4			0.1			0.4
Impact of income attributable to noncontrolling interests		(1.9	)		(2.3	)		(2.8	)

Effective tax rate		36.3	%		36.0	%		35.5	%

Net Deferred Tax Assets and Liabilities

The net deferred tax assets and liabilities are comprised as follows (amounts in thousands):


	Year Ended December 31,
	2013			2012
Current deferred taxes
Assets	$	121,097		$	105,639
Liabilities		(1,194	)		(1,178	)

Total deferred taxes-current		119,903			104,461

Noncurrent deferred taxes
Assets		103,221			142,065
Liabilities		(342,369	)		(325,812	)

Total deferred taxes-noncurrent		(239,148	)		(183,747	)

Total deferred tax liabilities	$	(119,245	)	$	(79,286	)

Reconciliation of Unrecognized Tax Benefits

The tabular reconciliation of unrecognized tax benefits for the years ended December 31, 2013, 2012 and 2011 is as follows (amounts in thousands).


	As of December 31,
	2013			2012			2011
Balance at January 1,	$	6,824		$	7,403		$	7,923
Additions based on tax positions related to the current year		50			200			750
Additions for tax positions of prior years		283			386			419
Reductions for tax positions of prior years		(1,260	)		(1,165	)		(1,628	)
Settlements		(2,528	)		—			(61	)

Balance at December 31,	$	3,369		$	6,824		$	7,403

- Definition

Tabular disclosure of tax positions taken in the tax returns filed or to be filed for which it is more likely than not that the tax position will not be sustained upon examination by taxing authorities (i.e., uncertain tax positions) and other types of income tax contingencies, including: (1) the policy on classification of interest and penalties; (2) a tabular reconciliation of the total amounts of unrecognized tax benefits at the beginning and end of the period; the total amount(s) of: (3) unrecognized tax benefits that, if recognized, would affect the effective tax rate, and (4) interest and penalties recognized in each of the income statement and balance sheet; (5) for positions for which it is reasonably possible that the total amounts unrecognized will significantly change within 12 months of the reporting date the: (i) nature of the uncertainty, (ii) nature of the event that could occur that would cause the change, and (iii) an estimate of the range of the reasonably possible change or a statement that an estimate of the range cannot be made; and (6) a description of tax years that remain subject to examination by major tax jurisdictions.

+ References+ Details

Lease Commitments (Tables)

12 Months Ended

Dec. 31, 2013

Summary of Property Under Capital Lease

A summary of property under capital lease follows (amounts in thousands):


	As of December 31,
	2013			2012
Land, buildings and equipment	$	27,636		$	27,836
Less: accumulated amortization		(27,382	)		(26,540	)

	$	254		$	1,296

Future Minimum Rental Payments Under Lease Commitments

Future minimum rental payments under lease commitments with a term of more than one year as of December 31, 2013, are as follows (amounts in thousands):


Year	Capital Leases			Operating Leases
	(000s)
2014	$	2,026		$	55,812
2015		1,218			45,807
2016		1,167			37,769
2017		1,077			21,391
2018		1,086			17,322
Later years		4,030			128,636

Total minimum rental	$	10,604		$	306,737

Less: Amount representing interest		(3,971	)

Present value of minimum rental commitments		6,633
Less: Current portion of capital lease obligations		(774	)

Long-term portion of capital lease obligations	$	5,859

Relationship with Universal Health Realty Income Trust and Related Party Transactions (Tables)

12 Months Ended

Dec. 31, 2013

Remaining Renewal Options and Terms for Each of Four Hospital Facilities Leased from Trust

The table below details the remaining renewal options and terms for each of our four hospital facilities leased from the Trust:

Hospital Name

Type of Facility

Annual
Minimum
Rent

End of Lease Term

Renewal
Term
(years)

McAllen Medical Center

Acute Care

5,485,000

December, 2016

(a)

Wellington Regional Medical Center

Acute Care

3,030,000

December, 2016

(b)

Southwest Healthcare System, Inland Valley Campus

Acute Care

2,648,000

December, 2016

(b)

The Bridgeway

Behavioral Health

930,000

December, 2014

(c)

(a)	We have three 5-year renewal options at existing lease rates (through 2031).

(b)	We have one 5-year renewal options at existing lease rates (through 2021) and two 5-year renewal options at fair market value lease rates (2022 through 2031).

(c)	We have two 5-year renewal options at fair market value lease rates (2015 through 2024).

Pension Plan (Tables)

12 Months Ended

Dec. 31, 2013

Reconciliation of Defined Benefit Pension Plan

The following table shows the reconciliation of the defined benefit pension plan as of December 31, 2013 and 2012:


	2013			2012
	(000s)
Change in plan assets:
Fair value of plan assets at beginning of year	$	104,074		$	87,940
Actual return (loss) on plan assets		8,037			13,824
Employer contributions		0			7,786
Benefits paid		(5,042	)		(4,946	)
Administrative expenses		(600	)		(530	)

Fair value of plan assets at end of year	$	106,469		$	104,074
Change in benefit obligation:
Benefit obligation at beginning of year	$	114,529		$	108,446
Service cost		1,060			1,144
Interest cost		4,528			4,659
Benefits paid		(5,042	)		(4,946	)
Actuarial (gain) loss		(11,517	)		5,226

Benefit obligation at end of year	$	103,558		$	114,529
Amounts recognized in the Consolidated Balance Sheet:
Other non-current assets	$	2,911		$	0
Other non-current liabilities		0			10,455

Total amounts recognized at end of year	$	2,911		$	10,455

Components of Net Periodic Pension Cost (Benefit)


	2013			2012			2011
	(000s)
Components of net periodic cost (benefit)
Service cost	$	1,060		$	1,144		$	1,162
Interest cost		4,528			4,659			5,047
Expected return on plan assets		(7,601	)		(7,301	)		(6,566	)
Recognized actuarial loss		3,305			4,219			2,427

Net periodic cost	$	1,292		$	2,721		$	2,070

Measurement Dates


	2013		2012
Measurement Dates
Benefit obligations		12/31/2013		12/31/2012
Fair value of plan assets		12/31/2013		12/31/2012

Weighted-average Assumptions for Net Periodic Benefit Cost


	2013			2012
Weighted average assumptions as of December 31
Discount rate		4.95	%		4.05	%
Rate of compensation increase		4.00	%		4.00	%

Weighted Average Assumptions


	2013			2012			2011
Weighted-average assumptions for net periodic benefit cost calculations
Discount rate		4.05	%		4.40	%		5.54	%
Expected long-term rate at return on plan assets		7.50	%		8.00	%		8.00	%
Rate of compensation increase		4.00	%		4.00	%		4.00	%

Market Values of Our Pension Plan Assets

The market values of our pension plan assets at December 31, 2013 and December 31, 2012 by asset category are as follows:


December 31, 2013	Total		Level 1		Level 2		Level 3
Equities:
U.S. Large Cap	$	8,600	$	—	$	8,600	$	—
U.S. Mid Cap		2,740		—		2,740		—
U.S. Small Cap		2,725		—		2,725		—
International Developed		6,508		—		6,508		—
Emerging Markets		4,154		—		4,154		—
Fixed income:
Core Fixed Income		23,222		—		23,222		—
Long Duration Fixed Income		55,933		—		55,933		—
Real Estate:
REIT Fund		2,124		—		2,124		—
Cash/Currency:
Cash Equivalents		463		—		463		—

Total market value	$	106,469	$	—	$	106,469	$	—


December 31, 2012	Total		Level 1		Level 2		Level 3
Equities:
U.S. Large Cap	$	22,800	$	—	$	22,800	$	—
U.S. Mid Cap		1,566		—		1,566		—
U.S. Small-Mid Cap		7,738		—		7,738		—
U.S. Small Cap		1,583		—		1,583		—
International Developed		10,779		—		10,779		—
Emerging Markets		3,912		—		3,912		—
Fixed income:
Long Duration Fixed Income		51,355		—		51,355		—
Real Estate:
REIT Fund		3,904		—		3,904		—
Cash/Currency:
Cash Equivalents		437		—		437		—

Total market value	$	104,074	$	—	$	104,074	$	—

Estimated Future Benefit

There will be benefit payments under this plan beyond 2023.


Estimated Future Benefit Payments (000s)
2014	$	5,677
2015		5,966
2016		6,205
2017		6,407
2018		6,612
2019-2023		34,931

Total	$	65,798

Plan Assets


	2013			2012
Plan Assets
Asset Category
Equity securities		23	%		47	%
Fixed income securities		74	%		49	%
Other		3	%		4	%

Total		100	%		100	%

Asset Allocation Policy and Ranges Established in accordance with Overall Risk and Return Objectives of Portfolio

The following asset allocation policy and ranges have been established in accordance with the overall risk and return objectives of the portfolio:


	As of 12/31/13			Permitted Range
Total Equity		23	%		10-30	%
Total Fixed Income		74	%		70-90	%
Other		3	%		0-10	%

Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2013

Segment Reporting


2013	Acute Care Hospital Services			Behavioral Health Services			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	13,469,269		$	6,294,046			—		$	19,763,315
Gross outpatient revenues	$	6,828,307		$	744,510		$	40,460		$	7,613,277
Total net revenues	$	3,576,369		$	3,667,967		$	39,486		$	7,283,822
Income (loss) before allocation of corporate overhead and income taxes	$	342,191		$	895,869		($	368,728	)	$	869,332
Allocation of corporate overhead	($	184,444	)	($	89,447	)	$	273,891		$	0
Income (loss) after allocation of corporate overhead and before income taxes	$	157,747		$	806,422		($	94,837	)	$	869,332
Total assets	$	3,125,626		$	4,966,182		$	219,915		$	8,311,723


2012	Acute Care Hospital Services			Behavioral Health Services			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	12,406,567		$	5,764,370			—		$	18,170,937
Gross outpatient revenues	$	6,134,615		$	646,177		$	48,183		$	6,828,975
Total net revenues	$	3,461,416		$	3,460,141		$	39,843		$	6,961,400
Income (loss) before allocation of corporate overhead and income taxes	$	337,385		$	838,603		($	412,325	)	$	763,663
Allocation of corporate overhead	($	162,056	)	($	84,597	)	$	246,653		$	0
Income (loss) after allocation of corporate overhead and before income taxes	$	175,329		$	754,006		($	165,672	)	$	763,663
Total assets	$	2,984,169		$	4,979,965		$	236,709		$	8,200,843


2011	Acute Care Hospital Services			Behavioral Health Services			Other			Total Consolidated
	(Dollar amounts in thousands)
Gross inpatient revenues	$	11,770,248		$	5,507,728			—		$	17,277,976
Gross outpatient revenues	$	5,431,146		$	606,876		$	53,240		$	6,091,262
Total net revenues	$	3,423,957		$	3,308,862		$	27,403		$	6,760,222
Income (loss) before allocation of corporate overhead and income taxes	$	352,931		$	729,142		($	385,737	)	$	696,336
Allocation of corporate overhead	($	131,225	)	($	62,710	)	$	193,935		$	0
Income (loss) after allocation of corporate overhead and before income taxes	$	221,706		$	666,432		($	191,802	)	$	696,336
Total assets	$	2,782,102		$	4,373,379		$	509,764		$	7,665,245

- Definition

Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss.

+ References+ Details

Quarterly Results (Tables)

12 Months Ended

Dec. 31, 2013

Summary of Quarterly Financial Data

The following tables summarize the quarterly financial data for the two years ended December 31, 2013 and 2012:


2013	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Net revenues	$	1,831,632	$	1,834,975	$	1,816,369	$	1,800,846	$	7,283,822
Net income	$	129,935	$	167,803	$	123,099	$	133,186	$	554,023
Less: Net income attributable to noncontrolling interests	$	10,151	$	15,962	$	8,512	$	8,665	$	43,290

Net income attributable to UHS	$	119,784	$	151,841	$	114,587	$	124,521	$	510,733

Earnings per share attributable to UHS-Basic:

Total basic earnings per share	$	1.23	$	1.55	$	1.17	$	1.27	$	5.21

Earnings per share attributable to UHS-Diluted:

Total diluted earnings per share	$	1.21	$	1.53	$	1.15	$	1.24	$	5.14

2012	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Net revenues	$	1,793,036	$	1,723,084	$	1,680,353	$	1,764,927	$	6,961,400
Net income	$	142,570	$	117,444	$	81,373	$	147,660	$	489,047
Less: Net income attributable to noncontrolling interests	$	13,963	$	9,883	$	9,556	$	12,199	$	45,601

Net income attributable to UHS	$	128,607	$	107,561	$	71,817	$	135,461	$	443,446

Earnings per share attributable to UHS-Basic:

Total basic earnings per share	$	1.33	$	1.11	$	0.74	$	1.39	$	4.57

Earnings per share attributable to UHS-Diluted:

Total diluted earnings per share	$	1.31	$	1.10	$	0.73	$	1.39	$	4.53

Supplemental Condensed Consolidating Financial Information (Tables)

12 Months Ended

Dec. 31, 2013

Condensed Consolidating Statements of Income

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2013

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net revenues before provision for doubtful accounts	$	0		$	5,658,699		$	2,780,983		$	(28,644	)	$	8,411,038
Less: Provision for doubtful accounts		0			657,106			470,110			0			1,127,216

Net Revenues		0			5,001,593			2,310,873			(28,644	)		7,283,822
Operating charges:
Salaries, wages and benefits		0			2,573,205			1,031,415			0			3,604,620
Other operating expenses		0			972,170			523,382			(26,808	)		1,468,744
Supplies expense		0			510,078			311,011			0			821,089
Depreciation and amortization		0			236,958			100,214			0			337,172
Lease and rental expense		0			62,518			37,076			(1,836	)		97,758
EHR incentive income		0			(43,027	)		(17,997	)		0			(61,024	)

		0			4,311,902			1,985,101			(28,644	)		6,268,359

Income from operations		0			689,691			325,772			0			1,015,463
Interest expense		139,793			3,365			2,973			0			146,131
Interest (income) expense, affiliate		0			84,640			(84,640	)		0			0
Equity in net income of consolidated affiliates		(597,020	)		(141,004	)		0			738,024			0

Income before income taxes		457,227			742,690			407,439			(738,024	)		869,332
Provision for income taxes		(53,506	)		262,346			106,469			0			315,309

Net income		510,733			480,344			300,970			(738,024	)		554,023
Less: Income attributable to noncontrolling interests		0			0			43,290			0			43,290

Net income attributable to UHS	$	510,733		$	480,344		$	257,680		$	(738,024	)	$	510,733

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2012

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net revenues before provision for doubtful accounts	$	0		$	5,152,816		$	2,562,781		$	(27,526	)	$	7,688,071
Less: Provision for doubtful accounts		0			411,538			315,133			0			726,671

Net Revenues		0			4,741,278			2,247,648			(27,526	)		6,961,400
Operating charges:
Salaries, wages and benefits		0			2,452,187			988,730			0			3,440,917
Other operating expenses		0			899,274			502,592			(25,744	)		1,376,122
Supplies expense		0			496,848			302,773			0			799,621
Depreciation and amortization		0			210,867			91,559			0			302,426
Lease and rental expense		0			59,596			37,071			(1,782	)		94,885
Transaction costs		0			5,716			0			0			5,716
EHR incentive income		0			(14,284	)		(15,754	)		0			(30,038	)
Costs related to extinguishment of debt		29,170			0			0			0			29,170

		29,170			4,110,204			1,906,971			(27,526	)		6,018,819

Income from operations		(29,170	)		631,074			340,677			0			942,581
Interest expense		172,467			3,749			2,702			0			178,918
Interest (income) expense, affiliate		0			93,363			(93,363	)		0			0
Equity in net income of consolidated affiliates		(567,906	)		(141,983	)		0			709,889			0

Income before income taxes		366,269			675,945			431,338			(709,889	)		763,663
Provision for income taxes		(77,177	)		237,072			114,721			0			274,616

Net income		443,446			438,873			316,617			(709,889	)		489,047
Less: Income attributable to noncontrolling interests		0			0			45,601			0			45,601

Net income attributable to UHS	$	443,446		$	438,873		$	271,016		$	(709,889	)	$	443,446

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2011

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net revenues before provision for doubtful accounts	$	0		$	4,917,358		$	2,465,916		$	(26,476	)	$	7,356,798
Less: Provision for doubtful accounts		0			340,121			256,455			0			596,576

Net revenues		0			4,577,237			2,209,461			(26,476	)		6,760,222
Operating charges:
Salaries, wages and benefits		0			2,371,961			954,417			0			3,326,378
Other operating expenses		200			923,579			454,601			(24,687	)		1,353,693
Supplies expense		0			499,200			306,289			0			805,489
Depreciation and amortization		0			207,981			79,230			0			287,211
Lease and rental expense		0			60,768			31,344			(1,789	)		90,323

		200			4,063,489			1,825,881			(26,476	)		5,863,094

Income from operations		(200	)		513,748			383,580			0			897,128
Interest expense		195,404			3,212			2,176			0			200,792
Interest (income) expense, affiliate		0			87,205			(87,205	)		0			0
Equity in net income of consolidated affiliates		(518,797	)		(157,009	)		0			675,806			0

Income before income taxes		323,193			580,340			468,609			(675,806	)		696,336
Provision for income taxes		(74,974	)		198,091			124,349			0			247,466

Net income		398,167			382,249			344,260			(675,806	)		448,870
Less: Income attributable to noncontrolling interests		0			0			50,703			0			50,703

Net income attributable to UHS	$	398,167		$	382,249		$	293,557		$	(675,806	)	$	398,167

Condensed Consolidating Statements of Comprehensive Income

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2013

(amounts in thousands)


	Parent			Guarantors		Non Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Net income	$	510,733		$	480,344	$	300,970	$	(738,024	)	$	554,023
Other comprehensive income (loss):
Unrealized derivative gains on cash flow hedges		16,963			0		0		0			16,963
Amortization of terminated hedge		(336	)		0		0		0			(336	)
Minimum Pension Liability		14,657			14,657		0		(14,657	)		14,657

Other comprehensive income before tax		31,284			14,657		0		(14,657	)		31,284
Income tax expense related to items of other comprehensive income		11,940			5,670		0		(5,670	)		11,940

Total other comprehensive income, net of tax		19,344			8,987		0		(8,987	)		19,344

Comprehensive income		530,077			489,331		300,970		(747,011	)		573,367
Less: Comprehensive income attributable to noncontrolling interests		0			0		43,290		0			43,290

Comprehensive income attributable to UHS	$	530,077		$	489,331	$	257,680	$	(747,011	)	$	530,077

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2012

(amounts in thousands)


	Parent			Guarantors		Non Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Net income	$	443,446		$	438,873	$	316,617	$	(709,889	)	$	489,047
Other comprehensive income (loss):
Unrealized derivative gains on cash flow hedges		6,677			0		0		0			6,677
Amortization of terminated hedge		(336	)		0		0		0			(336	)
Minimum Pension Liability		4,986			4,986		0		(4,986	)		4,986

Other comprehensive income before tax		11,327			4,986		0		(4,986	)		11,327
Income tax expense related to items of other comprehensive income		4,306			1,898		0		(1,898	)		4,306

Total other comprehensive income, net of tax		7,021			3,088		0		(3,088	)		7,021

Comprehensive income		450,467			441,961		316,617		(712,977	)		496,068
Less: Comprehensive income attributable to noncontrolling interests		0			0		45,601		0			45,601

Comprehensive income attributable to UHS	$	450,467		$	441,961	$	271,016	$	(712,977	)	$	450,467


UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME
FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2011 (amounts in thousands)
	Parent			Guarantors			Non Guarantors		Consolidating Adjustments			Total Consolidated Amounts
Net income	$	398,167		$	382,249		$	344,260	$	(675,806	)	$	448,870
Other comprehensive income (loss):
Unrealized derivative gains on cash flow hedges		(37,477	)		0			0		0			(37,477	)
Amortization of terminated hedge		(336	)		0			0		0			(336	)
Minimum Pension Liability		(12,397	)		(12,397	)		0		12,397			(12,397	)

Other comprehensive income before tax		(50,210	)		(12,397	)		0		12,397			(50,210	)
Income tax expense related to items of other comprehensive income		(19,174	)		(4,691	)		0		4,691			(19,174	)

Total other comprehensive income, net of tax		(31,036	)		(7,706	)		0		7,706			(31,036	)

Comprehensive income		367,131			374,543			344,260		(668,100	)		417,834
Less: Comprehensive income attributable to noncontrolling interests		0			0			50,703		0			50,703

Comprehensive income attributable to UHS	$	367,131		$	374,543		$	293,557	$	(668,100	)	$	367,131

Condensed Consolidating Balance Sheet

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING BALANCE SHEET

AS OF DECEMBER 31, 2013

(amounts in thousands)


	Parent		Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Assets
Current assets:
Cash and cash equivalents	$	0	$	7,990		$	9,248		$	0		$	17,238
Accounts receivable, net		0		799,898			317,063			0			1,116,961
Supplies		0		63,562			38,219			0			101,781
Deferred income taxes		76,719		43,184			0			0			119,903
Other current assets		0		63,786			12,660			0			76,446

Total current assets		76,719		978,420			377,190			0			1,432,329

Investments in subsidiaries		6,378,499		1,476,911			0			(7,855,410	)		0
Intercompany receivable		226,592		0			531,411			(758,003	)		0
Intercompany note receivable		0		0			982,568			(982,568	)		0
Property and equipment		0		4,093,914			1,597,988			0			5,691,902
Less: accumulated depreciation		0		(1,478,758	)		(770,975	)		0			(2,249,733	)

		0		2,615,156			827,013			0			3,442,169

Other assets:
Goodwill		0		2,552,190			496,826			0			3,049,016
Deferred charges		49,866		5,577			2,438			0			57,881
Other		8,411		251,365			70,552			0			330,328

	$	6,740,087	$	7,879,619		$	3,287,998		$	(9,595,981	)	$	8,311,723

Liabilities and Stockholders’ Equity
Current liabilities:
Current maturities of long-term debt	$	97,403		916			993			0		$	99,312
Accounts payable and accrued liabilities		28,099		837,354			87,996			0			953,449
Federal and state taxes		4,963		2,164			0			0			7,127

Total current liabilities		130,465		840,434			88,989			0			1,059,888

Intercompany payable		0		758,003			0			(758,003	)		0
Other noncurrent liabilities		7,591		199,104			77,894			0			284,589
Long-term debt		3,168,819		5,337			35,606			0			3,209,762
Intercompany note payable		0		982,568			0			(982,568	)		0
Deferred income taxes		183,233		55,915			0			0			239,148
Redeemable noncontrolling interests		0		0			218,107			0			218,107
UHS common stockholders’ equity		3,249,979		5,038,258			2,817,152			(7,855,410	)		3,249,979
Noncontrolling interest		0		0			50,250			0			50,250

Total equity		3,249,979		5,038,258			2,867,402			(7,855,410	)		3,300,229

	$	6,740,087	$	7,879,619		$	3,287,998		$	(9,595,981	)	$	8,311,723

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING BALANCE SHEET

AS OF DECEMBER 31, 2012

(amounts in thousands)


	Parent		Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
	Parent		Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Assets
Current assets:
Cash and cash equivalents	$	0	$	11,949		$	11,522		$	0		$	23,471
Accounts receivable, net		7,154		741,983			318,060			0			1,067,197
Supplies		0		61,100			37,900			0			99,000
Deferred income taxes		61,364		43,555			322			(780	)		104,461
Other current assets		2,188		75,117			10,631			0			87,936
Current assets held for sale		0		0			25,431			0			25,431

Total current assets		70,706		933,704			403,866			(780	)		1,407,496

Investments in subsidiaries		5,781,479		1,326,920			0			(7,108,399	)		0
Intercompany receivable		644,105		0			360,538			(1,004,643	)		0
Intercompany note receivable		0		0			1,007,453			(1,007,453	)		0
Property and equipment		0		3,867,471			1,500,874			0			5,368,345
Less: accumulated depreciation		0		(1,288,975	)		(697,135	)		0			(1,986,110	)

		0		2,578,496			803,739			0			3,382,235

Other assets:
Goodwill		820		2,554,531			481,414			0			3,036,765
Deferred charges		67,831		5,839			2,218			0			75,888
Other		9,645		209,558			79,256			0			298,459

	$	6,574,586	$	7,609,048		$	3,138,484		$	(9,121,275	)	$	8,200,843

Liabilities and Stockholders’ Equity
Current liabilities:
Current maturities of long-term debt	$	0		990			1,599			0		$	2,589
Accounts payable and accrued liabilities		10,985		740,484			138,088			0			889,557
Current liabilities held for sale		0		0			850			0			850
Federal and state taxes		0		900			620			(458	)		1,062

Total current liabilities		10,985		742,374			141,157			(458	)		894,058

Intercompany payable		0		1,004,643			0			(1,004,643	)		0
Other noncurrent liabilities		46,048		243,478			105,829			0			395,355
Long-term debt		3,676,940		5,372			45,119			0			3,727,431
Intercompany note payable		0		1,007,453			0			(1,007,453	)		0
Deferred income taxes		127,268		56,801			0			(322	)		183,747
Redeemable noncontrolling interests		0		0			234,303			0			234,303
UHS common stockholders’ equity		2,713,345		4,548,927			2,559,472			(7,108,399	)		2,713,345
Noncontrolling interest		0		0			52,604			0			52,604

Total equity		2,713,345		4,548,927			2,612,076			(7,108,399	)		2,765,949

	$	6,574,586	$	7,609,048		$	3,138,484		$	(9,121,275	)	$	8,200,843

Condensed Consolidating Statements of Cash Flows

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2013

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments		Total Consolidated Amounts
Net cash provided by operating activities	$	17,946		$	587,083		$	279,212		$	0	$	884,241

Cash Flows from Investing Activities:
Property and equipment additions, net of disposals		0			(269,419	)		(89,074	)		0		(358,493	)
Acquisition of property and businesses		0			(8,094	)		(4,542	)		0		(12,636	)
Proceeds received from sale of assets and businesses		0			7,916			29,566			0		37,482
Costs incurred for purchase and development of electronic health records application		0			(49,811	)		0			0		(49,811	)

Net cash used in investing activities		0			(319,408	)		(64,050	)		0		(383,458	)

Cash Flows from Financing Activities:
Reduction of long-term debt		(429,996	)		(109	)		(10,119	)		0		(440,224	)
Additional borrowings		15,761			0			0			0		15,761
Financing costs		(231	)		0			0			0		(231	)
Repurchase of common shares		(27,201	)		0			0			0		(27,201	)
Dividends paid		(19,621	)		0			0			0		(19,621	)
Issuance of common stock		5,708			0			0			0		5,708
Excess income tax benefits related to stock based compensation		20,121			0			0			0		20,121
Profit distributions to noncontrolling interests		0			0			(61,329	)		0		(61,329	)
Changes in intercompany balances with affiliates, net		417,513			(271,525	)		(145,988	)		0		0

Net cash used in financing activities		(17,946	)		(271,634	)		(217,436	)		0		(507,016	)

Decrease in cash and cash equivalents		0			(3,959	)		(2,274	)		0		(6,233	)
Cash and cash equivalents, beginning of period		0			11,949			11,522			0		23,471

Cash and cash equivalents, end of period	$	0		$	7,990		$	9,248		$	0	$	17,238

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2012

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net cash (used in) provided by operating activities	$	(37,648	)	$	594,606		$	242,273		$	0		$	799,231

Cash Flows from Investing Activities:
Property and equipment additions, net of disposals		0			(312,190	)		(51,002	)		0			(363,192	)
Acquisition of property and businesses		0			(513,596	)		(14,251	)		0			(527,847	)
Proceeds received from sale of assets and businesses		0			142,667			6,644			0			149,311
Costs incurred for purchase and development of electronic health records application		0			(54,362	)		0			0			(54,362	)
Return of Deposit on terminated purchase agreement		6,500			0			0			0			6,500

Net cash provided by (used in) investing activities		6,500			(737,481	)		(58,609	)		0			(789,590	)

Cash Flows from Financing Activities:
Reduction of long-term debt		(843,002	)		0			(8,258	)		1,613			(849,647	)
Additional borrowings		913,500			1,613			0			(1,613	)		913,500
Financing costs		(8,283	)		0			0			0			(8,283	)
Repurchase of common shares		(19,154	)		0			0			0			(19,154	)
Dividends paid		(58,395	)		0			0			0			(58,395	)
Issuance of common stock		5,435			0			0			0			5,435
Excess income tax benefits related to stock based compensation		16,040			0			0			0			16,040
Profit distributions to noncontrolling interests		0			0			(26,895	)		0			(26,895	)
Changes in intercompany balances with affiliates, net		25,007			119,990			(144,997	)		0			0

Net cash provided by (used in) financing activities		31,148			121,603			(180,150	)		0			(27,399	)

Increase (decrease) in cash and cash equivalents		0			(21,272	)		3,514			0			(17,758	)
Cash and cash equivalents, beginning of period		0			33,221			8,008			0			41,229

Cash and cash equivalents, end of period	$	0		$	11,949		$	11,522		$	0		$	23,471

UNIVERSAL HEALTH SERVICES, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS

FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2011

(amounts in thousands)


	Parent			Guarantors			Non Guarantors			Consolidating Adjustments			Total Consolidated Amounts
Net cash (used in) provided by operating activities	$	(12,558	)	$	518,462		$	204,779		$	0		$	710,683

Cash Flows from Investing Activities:
Property and equipment additions, net of disposals		0			(226,848	)		(58,834	)		0			(285,682	)
Acquisition of property and businesses		0			0			(29,466	)		0			(29,466	)
Proceeds received from sale of assets and businesses		0			0			67,592			0			67,592
Costs incurred for purchase and development of electronic health records application		0			(38,249	)		0			0			(38,249	)

Net cash used in investing activities		0			(265,097	)		(20,708	)		0			(285,805	)

Cash Flows from Financing Activities:
Reduction of long-term debt		(382,060	)		(1,442	)		0			1,985			(381,517	)
Additional borrowings		98,100			0			1,985			(1,985	)		98,100
Financing costs		(23,608	)		0			0			0			(23,608	)
Repurchase of common shares		(60,482	)		0			0			0			(60,482	)
Dividends paid		(19,466	)		0			0			0			(19,466	)
Issuance of common stock		4,779			0			0			0			4,779
Excess income tax benefits related to stock based compensation		7,568			0			0			0			7,568
Profit distributions to noncontrolling interests		0			0			(38,497	)		0			(38,497	)
Changes in intercompany balances with affiliates, net		387,727			(240,087	)		(147,640	)		0			0

Net cash provided by (used in) financing activities		12,558			(241,529	)		(184,152	)		0			(413,123	)

Increase (decrease) in cash and cash equivalents		0			11,836			(81	)		0			11,755
Cash and cash equivalents, beginning of period		0			21,385			8,089			0			29,474

Cash and cash equivalents, end of period	$	0		$	33,221		$	8,008		$	0		$	41,229

Business and Summary of Significant Accounting Policies - Additional Information (Detail) (USD $)	1 Months Ended	12 Months Ended																		12 Months Ended									12 Months Ended
	Sep. 01, 2013	Dec. 31, 2013 D Facility	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2013 Acute Care Hospitals	Dec. 31, 2012 Acute Care Hospitals	Dec. 31, 2011 Acute Care Hospitals	Dec. 31, 2013 Building Improvements Minimum	Dec. 31, 2013 Building Improvements Maximum	Dec. 31, 2013 Equipment Minimum	Dec. 31, 2013 Equipment Maximum	Dec. 31, 2013 Restricted Stock	Dec. 31, 2013 Medicare And Medicaid Sales	Dec. 31, 2012 Medicare And Medicaid Sales	Dec. 31, 2011 Medicare And Medicaid Sales	Dec. 31, 2013 Care Entities Sales	Dec. 31, 2012 Care Entities Sales	Dec. 31, 2011 Care Entities Sales	Dec. 31, 2013 Las Vegas, Nevada Acute Care Facilities	Dec. 31, 2013 Las Vegas, Nevada Sales	Dec. 31, 2012 Las Vegas, Nevada Sales	Dec. 31, 2011 Las Vegas, Nevada Sales	Dec. 31, 2013 Mcallen Edinburg Texas Sales	Dec. 31, 2012 Mcallen Edinburg Texas Sales	Dec. 31, 2011 Mcallen Edinburg Texas Sales	Dec. 31, 2013 Washington, District of Columbia Acute Care Facilities	Dec. 31, 2013 Laredo, Texas Acute Care Facilities	Dec. 31, 2013 Philadelphia, Pennsylvania Behavioral Health Care Facility	Dec. 31, 2013 Illinois D	Dec. 31, 2012 Illinois	Dec. 31, 2011 Illinois	Jan. 31, 2014 Illinois Subsequent Event	Dec. 31, 2013 Texas
Summary Of Business And Significant Accounting Policies [Line Items]
Percentage of revenue													38.00%	39.00%	41.00%	49.00%	49.00%	47.00%		14.00%	14.00%	15.00%	4.00%	4.00%	5.00%
Percentage of uninsured discount extended for unqualified charity patients		30.00%
Establishment of partial reserve in the allowance for doubtful accounts for self-pay balances outstanding from the date of discharge, in days		90
Establishment of fully reserve for self-pay balances outstanding from the date of discharge, in days		90
Establishment of fully reserve in the allowance for doubtful accounts for third party liability accounts from the date of discharge, in days		180
Accounts receivable																													$ 49,000,000	$ 70,000,000	$ 54,000,000	$ 27,000,000	$ 46,000,000
Receivables due outstanding in excess of 60 days																													28,000,000	51,000,000	41,000,000
Receivables days in excess																													60
Net of allowance for doubtful accounts		395,000,000	311,000,000
Patients treated at hospitals for non elective services gross income less than federal poverty guidelines		400.00%
Provision for doubtful accounts		1,127,216,000	726,671,000	596,576,000	1,020,000,000	635,000,000	519,000,000
Capitalize interest expense		4,900,000	5,700,000	400,000.0
Property and equipment, useful lives, maximum years								20 years	40 years	3 years	15 years
Depreciation expense		285,600,000	270,500,000	262,100,000
Impairment of goodwill or indefinite-lived intangible assets	0		0	0
Other intangible assets, net of accumulated amortization		97,000,000	99,000,000
Amount of estimated future payments related to physician-related contractual commitments		3,000,000	3,000,000
Amount of potential future financial obligations		3,000,000
Acute care facilities with outside owners holding non-controlling minority interest		5
Percentage of non-controlling, minority ownership interests held by outside owners																			28.00%							20.00%	11.00%	20.00%
Redeemable non-controlling interest balances		218,000,000	234,000,000
Non-controlling interest balances		$ 50,000,000	$ 53,000,000
Anti-dilutive weighted average stock options excluded from computation of earnings per share		4,000.0	2,000,000	1,400,000
Restricted stock, vesting period												7 years

Summary of Changes in Carrying Amount of Goodwill (Detail) (USD $)
In Thousands, unless otherwise specified

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Goodwill [Line Items]

Goodwill, Beginning Balance

$ 3,036,765

$ 2,627,602

Goodwill acquired during the period

445,661

Goodwill divested during the period

(19,352)

Adjustments to goodwill

12,251

^[1]

(17,146)

^[2]

Goodwill, Ending Balance

3,049,016

3,036,765

Acute Care Services

Goodwill [Line Items]

Goodwill, Beginning Balance

382,696

389,484

Goodwill acquired during the period

11,110

Goodwill divested during the period

(17,450)

Adjustments to goodwill

315

^[1]

(448)

^[2]

Goodwill, Ending Balance

383,011

382,696

Behavioral Health Services

Goodwill [Line Items]

Goodwill, Beginning Balance

2,654,069

2,238,118

Goodwill acquired during the period

434,551

Goodwill divested during the period

(1,902)

Adjustments to goodwill

11,936

^[1]

(16,698)

^[2]

Goodwill, Ending Balance

$ 2,666,005

$ 2,654,069

[1]

The increase in the Behavioral Health Services' goodwill consists primarily of an amount that was reclassified from other assets.

[2]

The reduction to the Behavioral Health Services' goodwill consists primarily of a reclassification to "assets of facilities held for sale" and represents the goodwill attributable to Peak Behavioral Health Services which we agreed to divest pursuant to our agreement with the Federal Trade Commission in connection with our acquisition of Ascend Health Corporation in October, 2012. Adjustments to prior year purchase price allocations for Acute Care and Behavioral Health Services are also included.

Amounts Recognized in AOCI (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Accumulated Other Comprehensive Income (Loss) [Line Items]
Net Unrealized Gains (Losses) on Effective Cash Flow Hedges, beginning balance	$ (24,527)	$ (28,460)
Net Unrealized Gains (Losses) on Effective Cash Flow Hedges, Pre tax amount	16,627	6,341
Net Unrealized Gains (Losses) on Effective Cash Flow Hedges, Income tax effect	(6,270)	(2,408)
Net Unrealized Gains (Losses) on Effective Cash Flow Hedges, Change, net of income tax	10,357	3,933
Net Unrealized Gains (Losses) on Effective Cash Flow Hedges, ending balance	(14,170)	(24,527)	(28,460)
Minimum Pension Liability, beginning balance	(19,627)	(22,715)
Minimum Pension Liability, Pre tax amount	14,657	4,986
Minimum pension liability, income tax effect	(5,670)	(1,898)	(4,691)
Minimum Pension Liability, Change, net of income tax	8,987	3,088
Minimum Pension Liability, ending balance	(10,640)	(19,627)	(22,715)
Total AOCI, beginning balance	(44,154)	(51,175)
Total AOCI, Pre tax amount	31,284	11,327	(50,210)
Total AOCI, Income tax effect	(11,940)	(4,306)	19,174
Total AOCI, Change, net of income tax	19,344	7,021	(31,036)
Total AOCI, ending balance	$ (24,810)	$ (44,154)	$ (51,175)

Computation of Basic and Diluted Earnings per Share (Detail) (USD $) In Thousands, except Per Share data, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Basic and diluted:
Net Income									$ 554,023	$ 489,047	$ 448,870
Less: Net income attributable to noncontrolling interest									(43,290)	(45,601)	(50,703)
Less: Net income attributable to unvested restricted share grants									(294)	(497)	(521)
Net income attributable to UHS-basic and diluted									$ 510,439	$ 442,949	$ 397,646
Weighted average number of common shares-basic									98,033	96,821	97,199
Total basic earnings per share	$ 1.27	$ 1.17	$ 1.55	$ 1.23	$ 1.39	$ 0.74	$ 1.11	$ 1.33	$ 5.21	$ 4.57	$ 4.09
Weighted average number of common shares									98,033	96,821	97,199
Net effect of dilutive stock options and grants based on the treasury stock method									1,328	890	1,338
Weighted average number of common shares and equivalents-diluted									99,361	97,711	98,537
Total diluted earnings per share	$ 1.24	$ 1.15	$ 1.53	$ 1.21	$ 1.39	$ 0.73	$ 1.10	$ 1.31	$ 5.14	$ 4.53	$ 4.04

Acquisitions and Divestitures - Additional Information (Detail) (USD $)	12 Months Ended				12 Months Ended				3 Months Ended	12 Months Ended			12 Months Ended					3 Months Ended	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Jul. 31, 2011 Meadow Wood Behavioral Health System Bed	Dec. 31, 2012 Auburn Regional Medical Center	Jan. 31, 2012 Hospital San Juan Capestrano Bed	Dec. 31, 2011 Monte Vista Bed	Dec. 31, 2011 Red Rock Hospital Bed	Jun. 30, 2013 Two Thousand Thirteen Divestiture of Assets and Businesses Peak Behavioral Health Services	Dec. 31, 2013 Two Thousand Thirteen Divestiture of Assets and Businesses Peak Behavioral Health Services	Dec. 31, 2012 2012 Divestiture of Assets and Businesses	Dec. 31, 2012 2012 Divestiture of Assets and Businesses Peak Behavioral Health Services Bed	Dec. 31, 2012 2012 Divestiture of Assets and Businesses Auburn Regional Medical Center Bed	Dec. 31, 2012 2012 Divestiture of Assets and Businesses Hospital San Juan Capestrano	Dec. 31, 2012 2012 Divestiture of Assets and Businesses Behavioral Health Care Facility Facility	Dec. 31, 2011 Two Thousand Eleven Divestiture of Assets and Businesses	Dec. 31, 2013 2013 Acquisitions of Assets and Businesses	Dec. 31, 2012 2012 Acquisitions of Assets and Businesses	Dec. 31, 2012 2012 Acquisitions of Assets and Businesses	Dec. 31, 2011 2012 Acquisitions of Assets and Businesses	Dec. 31, 2012 2012 Acquisitions of Assets and Businesses Ascend Health Corporation	Dec. 31, 2012 2012 Acquisitions of Assets and Businesses Physician Practices and Various Real Property	Dec. 31, 2011 2011 Acquisitions of Assets and Businesses
Business Acquisition [Line Items]
Acquisition, cash paid																	$ 13,000,000		$ 528,000,000		$ 503,000,000	$ 25,000,000	$ 29,000,000
Net cash proceeds from divestiture of assets and businesses									24,000,000	37,000,000	149,000,000		93,000,000	50,000,000	6,000,000	68,000,000
Aggregate pre-tax net gain on the divestiture	3,080,000	26,419,000	442,000		26,000,000				3,000,000	3,000,000
Pro forma net revenues																			7,110,000,000	6,900,000,000
Pro forma net income attributable to UHS																			464,000,000	401,000,000
Pro forma net income attributable to UHS per diluted share																			$ 4.74	$ 4.06
Transaction costs incurred																				5,000,000
Transaction costs incurred, per diluted share																				$ 0.06
Net revenues																		$ 42,000,000
Number of acute care hospital beds included in acquisition													159
Number of non-operating behavioral health facilities															2
Number of beds												104
Number of beds included in divestiture				58		108	101	21

Aggregate Net Purchase Price of Facilities Allocated to Assets and Liabilities Based on their Estimated Fair Values (Detail) (USD $) In Thousands, unless otherwise specified				12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2012 2012 Acquisitions of Assets and Businesses
Business Acquisition [Line Items]
Working capital, net				$ 21,000
Property & equipment				60,000
Goodwill	3,049,016	3,036,765	2,627,602	446,000
Other assets				9,000
Income tax assets, net of deferred tax liabilities				(1,000)
Other liabilities				(7,000)
Cash paid in 2012 for acquisitions				$ 528,000

Net Purchase Price Allocation to Assets and Liabilities based on their Estimated Fair Value (Detail) (2011 Acquisitions of Assets and Businesses, USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2011
2011 Acquisitions of Assets and Businesses
Business Acquisition [Line Items]
Property, plant & equipment	$ 35,000
Other assets/deposits	11,000
Debt	(17,000)
Cash paid in 2011 for acquisitions and deposits	$ 29,000

Results of Operations for Former PSI Facilities Reflected as Discontinued Operations (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Acquisitions And Discontinued Operations [Line Items]
Net revenues	$ 7,813	$ 95,226	$ 159,218
Income (loss) from discontinued operations, before income taxes	932	(3,472)	10,422
Gain on divestiture	3,080	26,419	442
Income from discontinued operations, before income tax expense	4,012	22,947	10,864
Income tax expense	(1,506)	(8,688)	(4,113)
Income from discontinued operations, net of income taxes	$ 2,506	$ 14,259	$ 6,751

- Definition

Overall income (loss) from a disposal group that is classified as a component of the entity, before income tax, reported as a separate component of income before extraordinary items. Includes the following (before income tax): income (loss) from operations during the phase-out period, gain (loss) on disposal, provision (or any reversals of earlier provisions) for loss on disposal, and adjustments of a prior period gain (loss) on disposal.

+ References+ Details

- Definition

Tax effect allocated to a disposal group that is classified as a component of the entity reported as a separate component of income before extraordinary items. Includes the tax effects of the following: income (loss) from operations during the phase-out period, gain (loss) on disposal, provision (or any reversals of earlier provisions) for loss on disposal, and adjustments of a prior period gain (loss) on disposal.

+ References+ Details

- Definition

Amount of income (loss) from a disposal group, net of income tax before extraordinary items allocable to noncontrolling interests. Includes, net of tax, income (loss) from operations during the phase-out period, gain (loss) on disposal, provision (or any reversals of earlier provisions) for loss on disposal, and adjustments of a prior period gain (loss) on disposal.

+ References+ Details

Financial Instruments - Additional Information (Detail) (USD $)	12 Months Ended					12 Months Ended			12 Months Ended									3 Months Ended
	Dec. 31, 2011	Dec. 31, 2007	Dec. 31, 2013 Fair Value Hedge	Dec. 31, 2012 Fair Value Hedge	Dec. 31, 2011 Fair Value Hedge	Dec. 31, 2011 Forward Starting Interest Rate Swaps Derivative	Dec. 31, 2010 Forward Starting Interest Rate Swaps Derivative	Dec. 31, 2011 One Point Nine One Percent Forward Starting Interest Rate Swaps	Dec. 31, 2011 One Point Three Two Percent Forward Starting Interest Rate Swaps	Dec. 31, 2011 One Point Nine Six Percent Forward Starting Interest Rate Swaps	Dec. 31, 2011 Two Point Five Zero Percent Forward Starting Interest Rate Swaps	Dec. 31, 2010 Two Point Three Eight Percent Forward Starting Interest Rate Swaps	Dec. 31, 2013 Interest Rate Swap	Dec. 31, 2012 Interest Rate Swap	Dec. 31, 2007 Interest Rate Swap	Dec. 31, 2013 Interest Rate Swap Other Current Liabilities	Dec. 31, 2013 Interest Rate Swap Other Noncurrent Liabilities	Dec. 31, 2007 Four Point Eight Seven Percent Forward Starting Interest Rate Swaps	Dec. 31, 2007 Four Point Seven Six Percent Forward Starting Interest Rate Swaps	Dec. 31, 2011 Cash Flow Hedging Interest Rate Cap from December Twenty Eleven to December Twenty Twelve	Dec. 31, 2011 Cash Flow Hedging Interest Rate Cap from December Twenty Twelve to December Twenty Thirteen	Dec. 31, 2011 Cash Flow Hedging Forward Starting Interest Rate Swaps	Dec. 31, 2011 Cash Flow Hedging One Point Nine One Percent Forward Starting Interest Rate Swaps	Dec. 31, 2011 Cash Flow Hedging One Point Three Two Percent Forward Starting Interest Rate Swaps	Dec. 31, 2011 Cash Flow Hedging One Point Nine Six Percent Forward Starting Interest Rate Swaps	Dec. 31, 2011 Cash Flow Hedging Two Point Five Zero Percent Forward Starting Interest Rate Swaps	Dec. 31, 2010 Cash Flow Hedging Two Point Three Eight Percent Forward Starting Interest Rate Swaps
Derivative [Line Items]
Fair value of hedges outstanding			$ 0	$ 0	$ 0
Notional amount of interest rate cash flow hedges															150,000,000			75,000,000		450,000,000	400,000,000	425,000,000	225,000,000	75,000,000	25,000,000	100,000,000	600,000,000
Derivative cap interest rate	7.00%
Premium paid on interest rate cap	740,000
Maturity date of interest rate cash flow hedges	Dec. 01, 2013								Dec. 01, 2012	Dec. 01, 2013	Dec. 01, 2014	May 01, 2015						Oct. 01, 2011	Oct. 01, 2012
Number of additional forward starting interest rate swaps						6	4
Average fixed rate payable on interest rate swap								1.91%
Fixed rate payable on interest rate swap									1.32%	1.96%	2.50%	2.38%						4.87%	4.76%
Number of interest rate swaps		2
Reduction in the notional amount of interest rate swap																			50,000,000
Fair value of our interest rate swaps, liability													$ 24,000,000	$ 41,000,000		$ 19,000,000	$ 5,000,000

Summary of Long-Term Debt (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Debt Instrument [Line Items]
Accounts receivable securitization program	$ 240,000
Long-term debt	3,309,074	3,730,020
Less-Amounts due within one year	(99,312)	(2,589)
Long-term debt, net	3,209,762	3,727,431
Notes Payable And Mortgages Payable
Debt Instrument [Line Items]
Notes payable and Mortgages payable (including obligations under capitalized leases of $6,633 in 2013 and $8,267 in 2012) and term loans with varying maturities through 2037; weighted average interest rates of 5.9% in each of 2013 and 2012 (see Note 7 regarding capitalized leases)	37,553	47,216
Revolving Credit And Demand Notes
Debt Instrument [Line Items]
Line of credit facility amount outstanding	25,500	163,500
Term Loan A
Debt Instrument [Line Items]
Line of credit facility amount outstanding	935,308	983,438
Term Loan B Facility
Debt Instrument [Line Items]
Line of credit facility amount outstanding	543,527	737,176
Term Loan- A2
Debt Instrument [Line Items]
Line of credit facility amount outstanding	871,875	894,375
Revenue Bonds
Debt Instrument [Line Items]
Revenue bonds, interest at floating rates of 0.1% at December 31, 2013 and 0.2% at December 31, 2012, with varying maturities through 2015	5,300	5,300
Accounts Receivable Securitization Program
Debt Instrument [Line Items]
Accounts receivable securitization program	240,000	249,000
7.125% Senior Secured Notes due 2016
Debt Instrument [Line Items]
Senior Notes	400,011	400,015
7.00% Senior Unsecured Notes due 2018
Debt Instrument [Line Items]
Senior Notes	$ 250,000	$ 250,000

- Definition

Carrying amount of long-term debt, net of unamortized discount or premium, including current and noncurrent amounts. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.

+ References+ Details

Summary of Long-Term Debt (Parenthetical) (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Notes Payable And Mortgages Payable
Debt Instrument [Line Items]
Obligations under capitalized leases	$ 6,633	$ 8,267
Weighted average interest	5.90%	5.90%
Term Loans With Varying Maturities
Debt Instrument [Line Items]
Debt instruments, maturity date	2037
Term Loan A
Debt Instrument [Line Items]
Unamortized discount	3,340	4,612
Term Loan B Facility
Debt Instrument [Line Items]
Unamortized discount	6,473	8,724
Revenue Bonds
Debt Instrument [Line Items]
Interest at floating rates	0.10%	0.20%
Debt instruments, maturity date	2015
7.125% Senior Secured Notes due 2016
Debt Instrument [Line Items]
Debt instruments, maturity date	2016
Senior notes, interest rate	7.125%
Unamortized net premium	$ 11	$ 15
7.00% Senior Unsecured Notes due 2018
Debt Instrument [Line Items]
Senior notes, interest rate	7.00%
Debt instruments, maturity date	2018

Long-Term Debt - Additional Information (Detail) (USD $)	12 Months Ended						1 Months Ended	12 Months Ended	1 Months Ended				9 Months Ended						1 Months Ended	12 Months Ended						1 Months Ended		12 Months Ended									12 Months Ended								1 Months Ended	3 Months Ended							12 Months Ended	3 Months Ended	1 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Oct. 31, 2013	Dec. 31, 2013 ABR-based loans	Dec. 31, 2013 Accounts Receivable Securitization Facility	Sep. 29, 2010 7.00% Senior Unsecured Notes	Dec. 31, 2013 7.00% Senior Unsecured Notes	Sep. 29, 2010 7.00% Senior Unsecured Notes Debtor Optional Redemption Period 1	Sep. 29, 2010 7.00% Senior Unsecured Notes Debtor Optional Redemption Period 2	Sep. 29, 2010 7.00% Senior Unsecured Notes Debtor Optional Redemption Period 3	Jun. 30, 2006 Senior Notes 7.125%	Sep. 30, 2013 Senior Notes 7.125%	Jun. 30, 2008 Senior Notes 7.125%	Dec. 31, 2013 Credit Agreement And Securitization	Dec. 31, 2012 Credit Agreement And Securitization	Dec. 31, 2011 Credit Agreement And Securitization	Dec. 31, 2013 Amendment of Credit Facility	Sep. 30, 2012 Term Loan- A2	Dec. 31, 2013 Term Loan- A2	Dec. 31, 2012 Term Loan- A2	Dec. 31, 2013 Term Loan- A2 One Month Eurodollar Rate Plus Index Based Loans Minimum	Dec. 31, 2013 Term Loan- A2 One Month Eurodollar Rate Plus Index Based Loans Maximum	Dec. 31, 2013 Term Loan- A2 One Two Three Six Month Eurodollar Rate Plus Index Based Loans Minimum	Dec. 31, 2013 Term Loan- A2 One Two Three Six Month Eurodollar Rate Plus Index Based Loans Maximum	Sep. 30, 2012 Term Loan- A2 Amendment of Credit Facility	Dec. 31, 2013 Term Loan- A2 Amendment of Credit Facility	Dec. 31, 2013 Revolving Credit Facility	Sep. 30, 2012 Revolving Credit Facility	Dec. 31, 2013 Revolving Credit Facility One Month Eurodollar Rate Plus Index Based Loans Minimum	Dec. 31, 2013 Revolving Credit Facility One Month Eurodollar Rate Plus Index Based Loans Maximum	Dec. 31, 2013 Revolving Credit Facility One Two Three Six Month Eurodollar Rate Plus Index Based Loans	Dec. 31, 2013 Revolving Credit Facility One Two Three Six Month Eurodollar Rate Plus Index Based Loans Maximum	Dec. 31, 2013 Revolving Credit Facility Amendment of Credit Facility	Nov. 15, 2010 Revolving Credit Facility Amendment of Credit Facility	Sep. 30, 2012 Revolving Credit Facility Amendment of Credit Facility Extended Maturity	Dec. 31, 2013 Term Loan A	Dec. 31, 2012 Term Loan A	Sep. 30, 2012 Term Loan A	Dec. 31, 2013 Term Loan A One Month Eurodollar Rate Plus Index Based Loans Minimum	Dec. 31, 2013 Term Loan A One Month Eurodollar Rate Plus Index Based Loans Maximum	Dec. 31, 2013 Term Loan A One Two Three Six Month Eurodollar Rate Plus Index Based Loans Minimum	Dec. 31, 2013 Term Loan A One Two Three Six Month Eurodollar Rate Plus Index Based Loans Maximum	Dec. 31, 2013 Term Loan A Amendment of Credit Facility	Sep. 30, 2012 Term Loan A Amendment of Credit Facility Extended Maturity	Sep. 30, 2012 Term Loan B Facility	Dec. 31, 2013 Term Loan B Facility	Dec. 31, 2012 Term Loan B Facility	Dec. 31, 2013 Term Loan B Facility One Month Eurodollar Rate Plus Index Based Loans	Dec. 31, 2013 Term Loan B Facility One Two Three Six Month Eurodollar Rate Plus Index Based Loans	Dec. 31, 2013 Term Loan B Facility Amendment of Credit Facility	Dec. 31, 2013 Short Term on Demand Credit Facility	Dec. 31, 2013 Term Loan-A and Term Loan A2 facilities	Dec. 31, 2013 Term Loan-B facility	May 31, 2013 Tranche B-1 Term Loan Amendment of Credit Facility	May 31, 2013 Tranche B-1 Term Loan Amendment of Credit Facility Minimum
Debt Instrument [Line Items]
Line of credit facility, borrowing capacity																										$ 900,000,000									$ 800,000,000																				$ 745,900,000
Term loan interest rate description																																																							Borrowings under the Tranche B-1 term loan bear interest at a rate per annum equal to, at our election, one, two, three or six month LIBOR, plus an applicable margin of 2.25% or ABR plus an applicable margin of 1.25%
Applicable margin percentage on LIBOR																																																							2.25%
Applicable margin percentage on ABR																																																							1.25%
Minimum LIBOR rate for term loan																																																							1.00%
Minimum ABR rate for term loan																																																								2.00%
Line of credit facility, maturity date																										Aug. 15, 2016		Nov. 15, 2015									Nov. 15, 2015								Aug. 15, 2016
Line of credit facility amount outstanding																		3,160,000,000		871,875,000	894,375,000						872,000,000	800,000,000						800,000,000		777,000,000	935,308,000	983,438,000						939,000,000	892,000,000		543,527,000	737,176,000			550,000,000	25,000,000
Line of credit facility, available borrowing capacity																												755,000,000	23,000,000										43,000,000
Proceeds from the new term loan-A2 facility																			700,000,000
Variable interest rate																				1.00%
Variable rate basis																																															1.00%
Costs related to extinguishment of debt	0	29,170,000	0																																											29,000,000
Letters of credit, outstanding																		125,000,000										20,000,000
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%
Consolidated leverage ratio																						0.50%	1.25%	1.50%	2.25%					0.50%	1.25%	1.50%	2.25%							0.50%	1.25%	1.50%	2.25%						1.25%	2.25%
Current applicable margins					0.50%															1.50%								1.50%									1.50%										2.25%
Scheduled principal payments made																																																					72,000,000
Quarterly installment payments due in 2014	99,312,000	2,589,000																																																			72,000,000
Quarterly installment payments due in 2015	139,261,000																																																				77,000,000
Quarterly installment payments due in 2016	2,804,569,000																																																				46,000,000
Repayment of credit facility																																																						196,000,000
Accounts receivable securitization program credit facility, borrowing capacity				275,000,000
Accounts receivable securitization program credit facility, amount outstanding	240,000,000
Accounts receivable securitization program, additional capacity						35,000,000
Senior notes, issued							250,000,000					250,000,000
Senior notes, interest rate							7.00%					7.125%
Senior notes, maturity date								Oct. 01, 2018					Jun. 30, 2016
Unsecured Notes make-whole redemption price									103.50%	101.75%	100.00%
Treasury rate plus, basis points							50
Senior notes, repayment terms							Payable semiannually in arrears on April 1st and October 1st of each year					Interest on the 7.125% Notes is payable semiannually in arrears on June 30th and December 30th of each year
Line of credit facility additional borrowing capacity														150,000,000
Average amounts outstanding under Credit Agreement, Prior Credit Agreement, demand notes and accounts receivable securitization programs															2,900,000,000	2,900,000,000	2,900,000,000
Effective interest rate	3.60%	4.50%	4.60%												2.20%	2.90%	3.40%
Maximum amounts outstanding at any month-end															3,000,000,000	3,060,000,000	3,030,000,000
Fair value of debt	3,400,000,000	3,800,000,000
Long-term debt	$ 3,209,762,000	$ 3,727,431,000

Aggregate Maturities (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Long Term Debt Maturities Repayments Of Principal [Line Items]
2014	$ 99,312	$ 2,589
2015	139,261
2016	2,804,569
2017	1,798
2018	251,893
Later	12,241
Total	$ 3,309,074	$ 3,730,020

- Definition

+ References+ Details

Common Stock - Additional Information (Detail) (USD $)	12 Months Ended																						12 Months Ended						12 Months Ended					12 Months Ended			12 Months Ended											12 Months Ended						12 Months Ended
Common Stock - Additional Information (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2012 Special Cash Dividend	Dec. 31, 2013 Stock Options	Dec. 31, 2012 Stock Options	Dec. 31, 2011 Stock Options	Dec. 31, 2013 Stock Options	Dec. 31, 2012 Stock Options	Dec. 31, 2011 Stock Options	Dec. 31, 2013 Restricted Stock	Dec. 31, 2012 Restricted Stock	Dec. 31, 2011 Restricted Stock	Dec. 31, 2013 2001 Employees' Restricted Stock Purchase Plan	Dec. 31, 2012 2001 Employees' Restricted Stock Purchase Plan	Dec. 31, 2011 2001 Employees' Restricted Stock Purchase Plan	Dec. 31, 2010 2001 Employees' Restricted Stock Purchase Plan	Dec. 31, 2011 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer Fourth quarter of 2007 Issuance	Dec. 31, 2010 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer Fourth quarter of 2007 Issuance	Dec. 31, 2009 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer Fourth quarter of 2007 Issuance	Dec. 31, 2008 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer Fourth quarter of 2007 Issuance	Dec. 31, 2007 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer Fourth quarter of 2007 Issuance	Dec. 31, 2013 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2009 Issuance	Dec. 31, 2012 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2009 Issuance	Dec. 31, 2011 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2009 Issuance	Dec. 31, 2010 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2009 Issuance	Dec. 31, 2009 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2009 Issuance	Mar. 31, 2009 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2009 Issuance	Dec. 31, 2012 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2008 Issuance	Dec. 31, 2011 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2008 Issuance	Dec. 31, 2010 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2008 Issuance	Dec. 31, 2009 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2008 Issuance	Mar. 31, 2008 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer First Quarter of 2008 Issuance	Dec. 31, 2012 2001 Employees' Restricted Stock Purchase Plan Various Employees	Dec. 31, 2011 2001 Employees' Restricted Stock Purchase Plan Various Employees	Dec. 31, 2007 2001 Employees' Restricted Stock Purchase Plan Various Employees	Dec. 31, 2013 2005 Employees' Restricted Stock Purchase Plan	Dec. 31, 2012 2005 Employees' Restricted Stock Purchase Plan	Dec. 31, 2011 2005 Employees' Restricted Stock Purchase Plan	Dec. 31, 2013 Long Term Incentive Plans	Dec. 31, 2012 Long Term Incentive Plans	Dec. 31, 2011 Long Term Incentive Plans	Dec. 31, 2013 Stock Incentive Plan	Dec. 31, 2012 Stock Incentive Plan	Dec. 31, 2011 Stock Incentive Plan	Dec. 31, 2013 Class B	Dec. 31, 2010 Class B 2001 Employees' Restricted Stock Purchase Plan	Dec. 31, 2013 Class B 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board	Dec. 31, 2012 Class B 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board	Dec. 31, 2011 Class B 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board	Dec. 31, 2010 Class B 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board	Mar. 31, 2010 Class B 2001 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board	Dec. 31, 2013 Class B Stock Incentive Plan	Dec. 31, 2013 Class B 2010 Employees' Restricted Stock Purchase Plan	Dec. 31, 2013 Class B 2010 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board	Dec. 31, 2012 Class B 2010 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board	Dec. 31, 2012 Class B 2010 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board First Anniversary	Dec. 31, 2012 Class B 2010 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board Second Anniversary	Dec. 31, 2012 Class B 2010 Employees' Restricted Stock Purchase Plan Chief Executive Officer ("CEO") And Chairman Of The Board Third Anniversary	Dec. 31, 2013 Class B 2010 Employees' Restricted Stock Purchase Plan Various Employees	Dec. 31, 2012 Class B 2010 Employees' Restricted Stock Purchase Plan Various Employees	Dec. 31, 2011 Class B 2010 Employees' Restricted Stock Purchase Plan Various Employees	Dec. 31, 2013 Class B 2010 Employees' Restricted Stock Purchase Plan Various Employees Third Anniversary of Grant Date
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividends declared and paid, per share	$ 0.20	$ 0.60	$ 0.20	$ 0.40
Dividends declared and paid	$ 19,600,000	$ 58,400,000	$ 19,500,000	$ 38,900,000
Stock repurchase programs authorized to purchase, shares	10,000,000
Excess tax benefit from share based compensation	20,121,000	16,040,000	7,568,000
Compensation cost recognized	27,783,000	22,518,000	18,225,000		25,800,000	20,100,000	15,800,000											333,000	375,000				74,000	556,000	556,000	556,000	482,000		15,000	375,000				42,000	120,000		581,000	533,000	461,000	2,000,000	2,800,000	2,400,000						375,000	375,000	375,000	355,000			41,000	523,000	1,000,000				354,000	370,000	198,000
Compensation cost recognized, pre-tax charge								25,800,000	20,100,000	15,800,000
Compensation cost recognized, after-tax								16,100,000	12,500,000	9,800,000	853,000	1,400,000	1,200,000
Compensation cost recognized											1,400,000	2,300,000	2,000,000
Shares reserved																																														6,000,000	2,400,000						23,000,000
Stock options granted during period (net of cancellations)	2,889,750	2,966,850	2,894,500																																								2,737,725	2,621,161	2,473,500
Weighted-average grant date fair value of option granted																																											$ 13.33	$ 10.73	$ 11.62
Total in-the-money value of all stock options exercised during the year	70,900,000	54,400,000	28,900,000
Stock issued under employee stock purchase plan																																					90,587	117,901	98,366
Percentage of discount provided to eligible employees for purchase of shares under employee stock purchase plan																																					10.00%
Stock issued during period, net of cancellations	1,000,000																1,200,000
Issuance of restricted shares approved, shares																						61,362						109,850					62,190			22,250																49,472		10,000		54,127						21,500
Restricted shares price, per share																						$ 24.45						$ 20.26					$ 24.12			$ 29.62																$ 30.32		$ 80.36		$ 36.95						$ 53.21
Issuance of restricted shares, value																						1,500,000						2,200,000					1,500,000			659,000																1,500,000		803,600		2,000,000						1,100,000
Estimated compensation cost																																																$ 20,000						$ 760,000	$ 500,000					$ 183,000
Restricted Stock Purchase Plan, annual vesting percentage																																																									50.00%	25.00%	25.00%
Fully vested shares	1,864,982													39,831	62,044	78,133		15,341	15,341	15,340	15,340		27,463	27,462	27,462	27,463			15,548	15,546	15,548	15,548																12,368	12,368	12,368					27,063					10,000	750		10,000
Number of shares cancelled																																																													750
Stock-based compensation plans expired																	2010-03
Issuance upon conversion of shares																																														25,657,523

Schedule of Information Related to Stock Repurchase Programs (Detail) (USD $)
In Thousands, except Share data, unless otherwise specified

12 Months Ended

Dec. 31, 2013

Dec. 31, 2010

Stock Repurchase Programs Twenty Ten

Dec. 31, 2011

Stock Repurchase Programs Twenty Eleven

Dec. 31, 2012

Stock Repurchase Programs Twenty Twelve

Dec. 31, 2013

Stock Repurchase Programs Twenty Thirteen

Class of Stock [Line Items]

Total number of shares purchased as part of publicly announced programs

1,384,637

Total price paid for shares purchased as part of publicly announced programs

$ 50,576

Total number of shares purchased related to stock-based compensation plans

1,078,131

^[1]

217,649

^[1]

433,312

^[1]

427,170

^[1]

Total price paid for shares purchased related to stock-based compensation plans

$ 56,261

$ 9,906

$ 19,154

$ 27,201

Aggregate number of shares purchased

2,462,768

1,602,286

433,312

427,170

Aggregate price paid for shares purchased

$ 106,837

$ 60,482

$ 19,154

$ 27,201

Maximum number of shares that may yet be purchased under the publicly announced program

2,152,339

767,702

[1]

Schedule of Information Related to Stock Repurchase Programs (Parenthetical) (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Withholding Obligations
Class of Stock [Line Items]
Number of shares repurchased	427,170	432,562	217,649
Shares repurchased at an average price	$ 63.68	$ 44.28	$ 45.51
Restricted Stock
Class of Stock [Line Items]
Number of shares repurchased		750
Shares repurchased at an average price		$ 0.01

Assumptions Used in Black-Scholes Model to Determine Fair Value for Stock Option Awards Granted (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Volatility	36.00%	33.00%	29.00%
Interest rate	1.00%	1.00%	2.00%
Expected life (years)	3 years 7 months 6 days	3 years 6 months	3 years 6 months
Forfeiture rate	11.00%	10.00%	9.00%
Dividend yield	0.50%	0.60%	0.70%

Summary of Option Activities (Detail) (USD $)	12 Months Ended
Summary of Option Activities (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding Option, Number of shares, beginning balance	7,436,238	7,558,945	6,594,950
Granted, Number of Shares	2,889,750	2,966,850	2,894,500
Exercised, Number of Shares	(2,288,666)	(2,608,007)	(1,563,255)
Cancelled, Number of Shares	(416,364)	(481,550)	(367,250)
Outstanding Option, Number of shares, ending balance	7,620,958	7,436,238	7,558,945
Outstanding Option, Average Option Price, beginning balance	$ 36.31	$ 31.63	$ 25.16
Outstanding options vested and exercisable, Number of Shares	1,756,128
Granted, Average Option Price	$ 53.51	$ 37.01	$ 43.66
Exercised, Average Option Price	$ 32.27	$ 23.22	$ 26.38
Cancelled, Average Option Price	$ 43.93	$ 38.00	$ 32.60
Outstanding Option, Average Option Price, ending balance	$ 43.63	$ 36.31	$ 31.63
Outstanding options vested and exercisable, Average option price	$ 35.60
32.28 -$16.22
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High			$ 32.28
Range, Low			$ 16.22
54.79 -$38.12
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High			$ 54.79
Range, Low			$ 38.12
46.97 -$16.22
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High		$ 46.97	$ 46.97
Range, Low		$ 16.22	$ 16.22
54.79 -$16.22
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High	$ 54.79	$ 54.79	$ 54.79
Range, Low	$ 16.22	$ 16.22	$ 16.22
44.83 -$36.95
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High		$ 44.83
Range, Low		$ 36.95
79.79 -$53.38
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High	$ 79.79
Range, Low	$ 53.38
53.38 -$16.22
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High	$ 53.38
Range, Low	$ 16.22
79.79 -$30.32
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High	$ 79.79
Range, Low	$ 30.32
46.97 -$30.32
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range, High	$ 46.97
Range, Low	$ 30.32

Schedule of Information about Unvested Options (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested options, Shares, beginning balance	5,250,926
Granted, Shares	2,889,750
Vested, Shares	(1,864,982)
Cancelled, Shares	(410,864)
Unvested options, Shares, ending balance	5,864,830
Unvested options, Weighted Average Grant Date Fair Value Per Share, beginning balance	$ 10.74
Granted, Weighted Average Grant Date Fair Value Per Share	$ 13.33
Vested, Weighted Average Grant Date Fair Value Per Share	$ 10.22
Canceled, Weighted Average Grant Date Fair Value Per Share	$ 11.66
Unvested options, Weighted Average Grant Date Fair Value Per Share, ending balance	$ 12.12

Schedule of Information about All Outstanding Options and Exercisable Options (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number, Options Outstanding	7,620,958	7,436,238	7,558,945	6,594,950
Weighted average exercise price, Options Outstanding	$ 43.63	$ 36.31	$ 31.63	$ 25.16
Aggregate intrinsic value, Options Outstanding	$ 286,740,433
Weighted average remaining contractual life, Options Outstanding	2 years 10 months 24 days
Number, Options Exercisable	1,756,128
Weighted Average Exercise Price, Options Exercisable	$ 35.60
Aggregate intrinsic value, Options Exercisable	$ 80,189,277
Weighted average remaining contractual life, Options Exercisable	1 year 7 months 6 days

Schedule of Weighted Average Remaining Contractual Life for Options Outstanding and Weighted Average Exercise Price Per Share for Exercisable Options (Detail) (USD $)

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2010

Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]

Options Outstanding, Shares

7,620,958

7,436,238

7,558,945

6,594,950

Options Outstanding, Weighted Average Exercise Price Per Share

$ 43.63

$ 36.31

$ 31.63

$ 25.16

Options Outstanding, Weighted Average Remaining Contractual Life (in Years)

2 years 10 months 24 days

Exercisable Options, Shares

1,756,128

Weighted average exercise price per share, Options Exercisable

$ 35.60

Expected to Vest Options , Shares

5,233,188

^[1]

Expected to Vest Options, Weighted Average Exercise Price Per Share

$ 46.04

^[1]

Range One

Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]

Range, Low

$ 30.32

Range, High

$ 36.95

Options Outstanding, Shares

3,183,583

Options Outstanding, Weighted Average Exercise Price Per Share

$ 35.14

Options Outstanding, Weighted Average Remaining Contractual Life (in Years)

2 years 4 months 24 days

Exercisable Options, Shares

1,259,453

Weighted average exercise price per share, Options Exercisable

$ 32.45

Expected to Vest Options , Shares

1,716,901

^[1]

Expected to Vest Options, Weighted Average Exercise Price Per Share

$ 36.91

^[1]

Range Two

Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]

Range, Low

$ 38.12

Range, High

$ 43.67

Options Outstanding, Shares

1,685,350

Options Outstanding, Weighted Average Exercise Price Per Share

$ 43.56

Options Outstanding, Weighted Average Remaining Contractual Life (in Years)

2 years 1 month 6 days

Exercisable Options, Shares

496,175

Weighted average exercise price per share, Options Exercisable

$ 43.58

Expected to Vest Options , Shares

1,061,101

^[1]

Expected to Vest Options, Weighted Average Exercise Price Per Share

$ 43.55

^[1]

Range Three

Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]

Range, Low

$ 44.83

Range, High

$ 53.38

Options Outstanding, Shares

2,724,525

Options Outstanding, Weighted Average Exercise Price Per Share

$ 53.36

Options Outstanding, Weighted Average Remaining Contractual Life (in Years)

4 years

Exercisable Options, Shares

500

Weighted average exercise price per share, Options Exercisable

$ 46.97

Expected to Vest Options , Shares

2,430,648

^[1]

Expected to Vest Options, Weighted Average Exercise Price Per Share

$ 53.36

^[1]

Range Four

Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]

Range, Low

$ 54.79

Range, High

$ 79.79

Options Outstanding, Shares

27,500

Options Outstanding, Weighted Average Exercise Price Per Share

$ 67.64

Options Outstanding, Weighted Average Remaining Contractual Life (in Years)

4 years

Exercisable Options, Shares

Expected to Vest Options , Shares

24,538

^[1]

Expected to Vest Options, Weighted Average Exercise Price Per Share

$ 67.64

^[1]

[1]	Assumes a weighted average forfeiture rate of 10.8%.

Components of Income Tax Expense Benefit (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Components Of Income Tax Expense Benefit [Line Items]
Current, Federal	$ 256,545	$ 254,021	$ 165,409
Current, Foreign	1,655	9,084	300
Current, State	28,490	39,076	22,901
Current, Total	286,690	302,181	188,610
Deferred, Federal and foreign	25,341	(21,408)	53,056
Deferred, State	3,278	(6,157)	5,800
Deferred, Total	28,619	(27,565)	58,856
Provision for income taxes	$ 315,309	$ 274,616	$ 247,466

- Definition

Amount of current federal tax expense (benefit) pertaining to income (loss) from continuing operations.

+ References+ Details

- Definition

Amount of current income tax expense (benefit) pertaining to taxable income (loss) from continuing operations.

+ References+ Details

- Definition

Amount of current state and local tax expense (benefit) pertaining to income (loss) from continuing operations.

+ References+ Details

- Definition

Amount of deferred income tax expense (benefit) pertaining to income (loss) from continuing operations.

+ References+ Details

- Definition

Amount of deferred state and local tax expense (benefit) pertaining to income (loss) from continuing operations.

+ References+ Details

Components of Deferred Taxes (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Schedule of Components of Deferred Tax Provision [Line Items]
Self-insurance reserves	$ 87,483	$ 112,587
Compensation accruals	49,302	47,571
State and foreign net operating loss carryforwards and other state and foreign deferred tax assets	57,204	54,874
Other currently non-deductible accrued liabilities	24,587	29,934
Net pension liability-OCI only	6,390	12,061
Doubtful accounts and other reserves	33,905	17,562
Other combined items-OCI only	9,018	15,282
Deferred income tax assets, Gross	267,889	289,871
Less: Valuation Allowance	(46,841)	(44,511)
Net deferred income tax assets:	221,048	245,360
Depreciable and amortizable assets	(337,669)	(322,317)
Other deferred tax liabilities	(2,624)	(2,329)
Net deferred income tax liabilities	$ (119,245)	$ (79,286)

Effective Tax Rates Calculation (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Schedule Of Effective Tax Rates Line Items
Provision for income taxes	$ 315,309	$ 274,616	$ 247,466
Income before income taxes	$ 869,332	$ 763,663	$ 696,336
Effective tax rate	36.30%	36.00%	35.50%

Income Taxes - Additional Information (Detail) (USD $)	12 Months Ended
Income Taxes - Additional Information (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Taxes [Line Items]
Favorable discrete tax items	$ 1,000,000	$ 1,000,000	$ 1,000,000
Deferred federal and state tax benefit	5,000,000	7,000,000
Future taxable income, amount	959,000,000
Deferred state tax benefit (net of the federal benefit)	3,278,000	(6,157,000)	5,800,000
Net operating losses	57,204,000	54,874,000
Deferred foreign tax benefit	3,000,000
Valuation allowances	46,841,000	44,511,000
Increase in estimated liabilities for uncertain tax positions	1,000,000	1,000,000
Decrease in estimated liabilities for uncertain tax positions due to the lapse of the statute of limitations	1,000,000
Impact of unrecognized tax benefits if recognized	2,000,000	4,000,000
Jurisdictions statutes of limitations expiration period	12 months
Period of expiration of the statute of limitations for certain jurisdictions	Within the next twelve months
Minimum
Income Taxes [Line Items]
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years	3
Maximum
Income Taxes [Line Items]
Accrued interest and penalties	1,000,000	1,000,000
Foreign and U.S. state and local jurisdictions have statutes of limitations, in years	4
State and Local Jurisdiction
Income Taxes [Line Items]
Deferred state tax benefit (net of the federal benefit)	47,000,000
Foreign Tax Authority
Income Taxes [Line Items]
Net operating losses	8,000,000
Allowance in relation to state tax benefit
Income Taxes [Line Items]
Valuation allowances	44,000,000	41,000,000
Net Operating Losses
Income Taxes [Line Items]
Increase in valuation allowance	3,000,000
Foreign Net Operating Losses
Income Taxes [Line Items]
Increase in valuation allowance	$ 3,000,000	$ 3,000,000

Reconciliation between Federal Statutory Rate and Effective Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Reconciliation of Statutory Federal Tax Rate [Line Items]
Federal statutory rate	35.00%	35.00%	35.00%
State taxes, net of federal income tax benefit	2.50%	3.00%	2.90%
Nondeductible transaction costs		0.20%
Divestiture Gain	0.30%
Other items	0.40%	0.10%	0.40%
Impact of income attributable to noncontrolling interests	(1.90%)	(2.30%)	(2.80%)
Effective tax rate	36.30%	36.00%	35.50%

Net Deferred Tax Assets and Liabilities (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Deferred Tax Assets And Liabilities [Line Items]
Current deferred taxes, Assets	$ 121,097	$ 105,639
Current deferred taxes, Liabilities	(1,194)	(1,178)
Total deferred taxes-current	119,903	104,461
Noncurrent deferred taxes, Assets	103,221	142,065
Noncurrent deferred taxes, Liabilities	(342,369)	(325,812)
Total deferred taxes-noncurrent	(239,148)	(183,747)
Net deferred income tax liabilities	$ (119,245)	$ (79,286)

- Definition

Amount after allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards expected to be realized or consumed within one year or operating cycle, if longer.

+ References+ Details

- Definition

Amount after allocation of valuation allowances of noncurrent deferred tax asset attributable to deductible temporary differences and carryforwards. Noncurrent assets are expected to be realized or consumed after one year (or the normal operating cycle, if longer).

+ References+ Details

- Definition

Amount of deferred tax liability attributable to taxable temporary differences, net of deferred tax asset attributable to deductible temporary differences and carryforwards net of valuation allowances expected to be realized or consumed within one year or operating cycle, if longer.

+ References+ Details

Reconciliation of Unrecognized Tax Benefits (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2011	Dec. 31, 2010
Reconciliation of Unrecognized Tax Benefits [Line Items]
Balance at January 1,	$ 6,824	$ 7,403	$ 7,923
Additions based on tax positions related to the current year	50	200	750
Additions for tax positions of prior years	283	386	419
Reductions for tax positions of prior years	(1,260)	(1,165)	(1,628)
Settlements	(2,528)		(61)
Balance at December 31,	$ 3,369	$ 6,824	$ 7,403

Summary of Property under Capital Lease (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Capital Leased Assets [Line Items]
Land, buildings and equipment	$ 27,636	$ 27,836
Less: accumulated amortization	(27,382)	(26,540)
Property under capital lease, Total	$ 254	$ 1,296

Future Minimum Rental Payments under Lease Commitments (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013
Future Minimum Payments Under Non-Cancelable Operating Leases With Initial Terms Of One-Year Or More [Line Items]
Capital Leases, 2014	$ 2,026
Capital Leases, 2015	1,218
Capital Leases, 2016	1,167
Capital Leases, 2017	1,077
Capital Leases, 2018	1,086
Capital Leases, Later years	4,030
Capital Leases, Total minimum rental	10,604
Less: Amount representing interest	(3,971)
Present value of minimum rental commitments	6,633
Less: Current portion of capital lease obligations	(774)
Long-term portion of capital lease obligations	5,859
Operating Leases, 2014	55,812
Operating Leases, 2015	45,807
Operating Leases, 2016	37,769
Operating Leases, 2017	21,391
Operating Leases, 2018	17,322
Operating Leases, Later years	128,636
Operating Leases, Total minimum rental	$ 306,737

Commitments and Contingencies - Additional Information (Detail) (USD $)														12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Nov. 15, 2010	Nov. 15, 2010 Minimum	Nov. 15, 2010 Maximum	Dec. 31, 2013 Letters Of Credit And Surety Bonds	Dec. 31, 2013 Revenue Cycle Data Processing Services	Dec. 31, 2013 Electronic Health Records Application	Dec. 31, 2013 Estimated Minimum Liabilities For Physician Commitments	Dec. 31, 2013 Related to Certain Equipment	Dec. 31, 2013 Construction Commitment	Dec. 31, 2013 Self Insurance Programs Letters Of Credit And Surety Bonds	Dec. 31, 2013 Other Debt Guarantees Letters Of Credit And Surety Bonds	Dec. 31, 2013 Professional And General Liability Psi Subsidiaries	Dec. 31, 2012 Professional And General Liability Psi Subsidiaries	Dec. 31, 2011 Professional And General Liability Psi Subsidiaries	Dec. 31, 2013 Location 2 Minimum	Dec. 31, 2013 Location 1 Minimum	Dec. 31, 2013 Puerto Rico	Dec. 31, 2013 Wind Storms Minimum	Dec. 31, 2013 Wind Storms Maximum	Dec. 31, 2013 Earthquake	Dec. 31, 2013 Earthquake United States	Dec. 31, 2013 Earthquake United States Minimum	Dec. 31, 2013 Earthquake United States Maximum	Dec. 31, 2013 Flood Location 2 Maximum	Dec. 31, 2013 Flood Location 1 Maximum	Jan. 31, 2008 Subsidiaries Minimum	Nov. 15, 2010 Subsidiaries Maximum	Dec. 31, 2013 Psychiatric Solutions Inc Minimum	Dec. 31, 2013 Psychiatric Solutions Inc Maximum	Dec. 31, 2013 Psychiatric Solutions Inc General and Professional Liability Insurance Policies Maximum	Dec. 31, 2013 Legacy Subsidiaries General and Professional Liability Insurance Policies Maximum	Dec. 31, 2013 Behavioral Health Facilities Acquired from Ascend Health Corporation General and Professional Liability Insurance Policies	Dec. 31, 2013 Behavioral Health Facilities Acquired from Ascend Health Corporation General and Professional Liability Insurance Policies Maximum	Oct. 30, 2012 Behavioral Health Facilities Acquired from Ascend Health Corporation General and Professional Liability Insurance Policies Maximum
Commitments and Contingencies Disclosure [Line Items]
Self-insured for professional and general liability	$ 206,000,000	$ 279,000,000																										$ 10,000,000		$ 3,000,000	$ 75,000,000	$ 3,000,000	$ 10,000,000		$ 20,000,000
Purchased several excess policies through commercial insurance carriers per occurrence																													200,000,000							250,000,000
Percentage of liability for claims paid under commercially insured coverage			10.00%
Liability for claims paid under commercially insured coverage				10,000,000	60,000,000
Minimum Insurance Deductible																	250,000	50,000																25,000
Self-insured for professional and general liability, current	44,000,000	48,000,000
Reduction in professional and general liability self-insurance reserves relating to prior years														81,000,000	27,000,000	11,000,000
Weighting given to company-specific metrics															100.00%	75.00%
General industry metrics															0.00%	25.00%
Compensation liability claims	64,000,000	66,000,000
Compensation and related benefits	34,000,000	35,000,000
Commercial property insurance policies covering catastrophic losses																			25,000,000		1,000,000,000	250,000,000	100,000,000
Percentage of insurance deductible																				3.00%	5.00%			1.00%	5.00%
Maximum insurance deductible																										500,000	250,000
Combined estimated future purchase obligations	261,000,000						76,000,000	149,000,000	3,000,000	33,000,000	153,000,000
Combined estimated future payments related to non contributory	223,000,000
Defined benefit pension plan estimated payments through 2088	205,000,000
Other retirement plan liabilities	17,000,000
Off-balance sheet contingent obligation						$ 85,000,000						$ 69,000,000	$ 16,000,000

Relationship with Universal Health Realty Income Trust and Related Party Transactions - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Related Party Transaction [Line Items]
Lease renewal period, years	5
Notice period on renewal of lease	90
Period of rights of refusal to leased facilities	180
Minimum
Related Party Transaction [Line Items]
Lease initial terms	13
Maximum
Related Party Transaction [Line Items]
Lease initial terms	15
Chief Executive Officer
Related Party Transaction [Line Items]
Estimated payments to acquire life insurance policies	$ 25,000,000
Payments to acquire life insurance policies	1,300,000	1,400,000	1,400,000
Chief Executive Officer \| Minimum
Related Party Transaction [Line Items]
Estimated death benefit proceeds	33,000,000
Chief Executive Officer \| Trust Owned by Chief Executive Officer
Related Party Transaction [Line Items]
Estimated payments to acquire life insurance policies	8,000,000
Relationship with Universal Health Realty Income Trust
Related Party Transaction [Line Items]
Trust outstanding shares held, percentage	6.10%
Advisory fee earned	2,400,000	2,100,000	2,000,000
Pre-tax share of income from the Trust	842,000	1,200,000	4,600,000
Share of income included in the share of trust		500,000	3,700,000
Carrying value of investment in Trust	8,100,000	9,300,000
Market value of investment in Trust	31,500,000	39,900,000
Rent expense under operating leases	$ 16,400,000	$ 16,300,000	$ 16,300,000
Non-controlling ownership interests by subsidiaries	100.00%

Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Detail) (USD $)

12 Months Ended

Dec. 31, 2013

McAllen Medical Center

Capital Leased Assets [Line Items]

Acute Care

$ 5,485,000

2016-12

15 years

^[1]

Wellington Regional Medical Center

Capital Leased Assets [Line Items]

Acute Care

3,030,000

2016-12

15 years

^[2]

Southwest Healthcare System, Inland Valley Campus

Capital Leased Assets [Line Items]

Acute Care

2,648,000

2016-12

15 years

^[2]

The Bridgeway

Capital Leased Assets [Line Items]

Behavioral Health

$ 930,000

2014-12

10 years

^[3]

[1]	We have three 5-year renewal options at existing lease rates (through 2031).
[2]	We have one 5-year renewal options at existing lease rates (through 2021) and two 5-year renewal options at fair market value lease rates (2022 through 2031).
[3]	We have two 5-year renewal options at fair market value lease rates (2015 through 2024).

Remaining Renewal Options and Terms for Hospital Facilities Leased from Trust (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2013 RenewalOptions
McAllen Medical Center
Capital Leased Assets [Line Items]
Number of renewal options at existing lease rates	3
Renewal options term at existing lease rates	5 years
Wellington Regional Medical Center
Capital Leased Assets [Line Items]
Number of renewal options at existing lease rates	1
Renewal options term at existing lease rates	5 years
Southwest Healthcare System, Inland Valley Campus
Capital Leased Assets [Line Items]
Number of renewal options at existing lease rates	2
Renewal options term at existing lease rates	5 years
The Bridgeway
Capital Leased Assets [Line Items]
Number of renewal options at existing lease rates	2
Renewal options term at existing lease rates	5 years
Maximum \| McAllen Medical Center
Capital Leased Assets [Line Items]
Renewal options at existing lease rates expiration year	2031
Maximum \| Wellington Regional Medical Center
Capital Leased Assets [Line Items]
Renewal options at existing lease rates expiration year	2021
Renewal options at fair market value lease rates expiration year	2031
Maximum \| Southwest Healthcare System, Inland Valley Campus
Capital Leased Assets [Line Items]
Renewal options at existing lease rates expiration year	2021
Renewal options at fair market value lease rates expiration year	2031
Maximum \| The Bridgeway
Capital Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2024
Minimum \| Wellington Regional Medical Center
Capital Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2022
Minimum \| Southwest Healthcare System, Inland Valley Campus
Capital Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2022
Minimum \| The Bridgeway
Capital Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2015

Pension Plan - Additional Information (Detail) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Defined Benefit Plan Disclosure [Line Items]
Amount of contributions to contributory plan	$ 29.9	$ 27.3	$ 21.7
Accumulated benefit obligation	102.3	112.7
Fair value of plan assets exceeded accumulated benefit obligation	4.1	8.6
Estimated net loss that will be amortized from accumulated other comprehensive income over the next fiscal year	$ 1.1

Schedule of Reconciliation of Defined Benefit Pension Plan (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets at beginning of year	$ 104,074	$ 87,940
Actual return (loss) on plan assets	8,037	13,824
Employer contributions	0	7,786
Benefits paid	(5,042)	(4,946)
Administrative expenses	(600)	(530)
Fair value of plan assets at end of year	106,469	104,074	87,940
Benefit obligation at beginning of year	114,529	108,446
Service cost	1,060	1,144	1,162
Interest cost	4,528	4,659	5,047
Benefits paid	(5,042)	(4,946)
Actuarial (gain) loss	(11,517)	5,226
Benefit obligation at end of year	103,558	114,529	108,446
Other non-current assets	2,911	0
Other non-current liabilities	0	10,455
Total amounts recognized at end of year	$ 2,911	$ 10,455

Components of Net Periodic Pension Cost Benefit (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Defined Benefit Plan Disclosure [Line Items]
Service cost	$ 1,060	$ 1,144	$ 1,162
Interest cost	4,528	4,659	5,047
Expected return on plan assets	(7,601)	(7,301)	(6,566)
Recognized actuarial loss	3,305	4,219	2,427
Net periodic cost	$ 1,292	$ 2,721	$ 2,070

Schedule of Weighted Average Assumptions (Detail)	12 Months Ended
Schedule of Weighted Average Assumptions (Detail)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Defined Benefit Plan Disclosure [Line Items]
Discount rate	4.95%	4.05%
Rate of compensation increase	4.00%	4.00%
Discount rate	4.05%	4.40%	5.54%
Expected long-term rate at return on plan assets	7.50%	8.00%	8.00%
Rate of compensation increase	4.00%	4.00%	4.00%

Schedule of Market Values of Pension Plan Assets (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	$ 106,469	$ 104,074	$ 87,940
Equity Securities \| U.S. Large Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	8,600	22,800
Equity Securities \| U.S. Mid Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	2,740	1,566
Equity Securities \| U.S. Small-Mid Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets		7,738
Equity Securities \| U.S. Small Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	2,725	1,583
Equity Securities \| International Developed
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	6,508	10,779
Equity Securities \| Emerging Markets
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	4,154	3,912
Fixed Income Securities \| Core Fixed Income
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	23,222
Fixed Income Securities \| Long Duration Fixed Income
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	55,933	51,355
Fixed income securities \| REIT Fund
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	2,124	3,904
Cash \| Cash Equivalents
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	463	437
Fair Value, Inputs, Level 2
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	106,469	104,074
Fair Value, Inputs, Level 2 \| Equity Securities \| U.S. Large Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	8,600	22,800
Fair Value, Inputs, Level 2 \| Equity Securities \| U.S. Mid Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	2,740	1,566
Fair Value, Inputs, Level 2 \| Equity Securities \| U.S. Small-Mid Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets		7,738
Fair Value, Inputs, Level 2 \| Equity Securities \| U.S. Small Cap
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	2,725	1,583
Fair Value, Inputs, Level 2 \| Equity Securities \| International Developed
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	6,508	10,779
Fair Value, Inputs, Level 2 \| Equity Securities \| Emerging Markets
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	4,154	3,912
Fair Value, Inputs, Level 2 \| Fixed Income Securities \| Core Fixed Income
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	23,222
Fair Value, Inputs, Level 2 \| Fixed Income Securities \| Long Duration Fixed Income
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	55,933	51,355
Fair Value, Inputs, Level 2 \| Fixed income securities \| REIT Fund
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	2,124	3,904
Fair Value, Inputs, Level 2 \| Cash \| Cash Equivalents
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	$ 463	$ 437

Schedule of Estimated Future Benefit Payments (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013
Defined Benefit Plan Disclosure [Line Items]
2014	$ 5,677
2015	5,966
2016	6,205
2017	6,407
2018	6,612
2019-2023	34,931
Total	$ 65,798

Schedule of Plan Assets Category (Detail)	12 Months Ended
Schedule of Plan Assets Category (Detail)	Dec. 31, 2013	Dec. 31, 2012
Defined Benefit Plan Disclosure [Line Items]
Total	100.00%	100.00%
Equity Securities
Defined Benefit Plan Disclosure [Line Items]
Asset Allocation	23.00%	47.00%
Fixed income securities
Defined Benefit Plan Disclosure [Line Items]
Asset Allocation	74.00%	49.00%
Other
Defined Benefit Plan Disclosure [Line Items]
Asset Allocation	3.00%	4.00%

Schedule of Asset Allocation Policy and Ranges for Overall Risk and Return Objectives of Portfolio (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Equity Funds
Defined Benefit Plan Disclosure [Line Items]
Assets allocation	23.00%
Permitted Range, minimum	10.00%
Permitted Range, maximum	30.00%
Fixed Income Funds
Defined Benefit Plan Disclosure [Line Items]
Assets allocation	74.00%
Permitted Range, minimum	70.00%
Permitted Range, maximum	90.00%
Other
Defined Benefit Plan Disclosure [Line Items]
Assets allocation	3.00%	4.00%
Permitted Range, minimum	0.00%
Permitted Range, maximum	10.00%

Segment Reporting (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Segment Reporting Information [Line Items]
Gross inpatient revenues									$ 19,763,315	$ 18,170,937	$ 17,277,976
Gross outpatient revenues									7,613,277	6,828,975	6,091,262
Total net revenues	1,800,846	1,816,369	1,834,975	1,831,632	1,764,927	1,680,353	1,723,084	1,793,036	7,283,822	6,961,400	6,760,222
Income (loss) before allocation of corporate overhead and income taxes									869,332	763,663	696,336
Allocation of corporate overhead									0	0	0
Income (loss) after allocation of corporate overhead and before income taxes									869,332	763,663	696,336
Total assets	8,311,723				8,200,843				8,311,723	8,200,843	7,665,245
Acute Care Hospital Services
Segment Reporting Information [Line Items]
Gross inpatient revenues									13,469,269	12,406,567	11,770,248
Gross outpatient revenues									6,828,307	6,134,615	5,431,146
Total net revenues									3,576,369	3,461,416	3,423,957
Income (loss) before allocation of corporate overhead and income taxes									342,191	337,385	352,931
Allocation of corporate overhead									(184,444)	(162,056)	(131,225)
Income (loss) after allocation of corporate overhead and before income taxes									157,747	175,329	221,706
Total assets	3,125,626				2,984,169				3,125,626	2,984,169	2,782,102
Behavioral Health Services
Segment Reporting Information [Line Items]
Gross inpatient revenues									6,294,046	5,764,370	5,507,728
Gross outpatient revenues									744,510	646,177	606,876
Total net revenues									3,667,967	3,460,141	3,308,862
Income (loss) before allocation of corporate overhead and income taxes									895,869	838,603	729,142
Allocation of corporate overhead									(89,447)	(84,597)	(62,710)
Income (loss) after allocation of corporate overhead and before income taxes									806,422	754,006	666,432
Total assets	4,966,182				4,979,965				4,966,182	4,979,965	4,373,379
Other
Segment Reporting Information [Line Items]
Gross outpatient revenues									40,460	48,183	53,240
Total net revenues									39,486	39,843	27,403
Income (loss) before allocation of corporate overhead and income taxes									(368,728)	(412,325)	(385,737)
Allocation of corporate overhead									273,891	246,653	193,935
Income (loss) after allocation of corporate overhead and before income taxes									(94,837)	(165,672)	(191,802)
Total assets	$ 219,915				$ 236,709				$ 219,915	$ 236,709	$ 509,764

Quarterly Results (Detail) (USD $) In Thousands, except Per Share data, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Quarterly Financial Data [Line Items]
Net revenues	$ 1,800,846	$ 1,816,369	$ 1,834,975	$ 1,831,632	$ 1,764,927	$ 1,680,353	$ 1,723,084	$ 1,793,036	$ 7,283,822	$ 6,961,400	$ 6,760,222
Net income	133,186	123,099	167,803	129,935	147,660	81,373	117,444	142,570	554,023	489,047	448,870
Less: Net income attributable to noncontrolling interests	8,665	8,512	15,962	10,151	12,199	9,556	9,883	13,963	43,290	45,601	50,703
Net income attributable to UHS	$ 124,521	$ 114,587	$ 151,841	$ 119,784	$ 135,461	$ 71,817	$ 107,561	$ 128,607	$ 510,733	$ 443,446	$ 398,167
Earnings per basic share attributable to UHS:	$ 1.27	$ 1.17	$ 1.55	$ 1.23	$ 1.39	$ 0.74	$ 1.11	$ 1.33	$ 5.21	$ 4.57	$ 4.09
Earnings per diluted share attributable to UHS:	$ 1.24	$ 1.15	$ 1.53	$ 1.21	$ 1.39	$ 0.73	$ 1.10	$ 1.31	$ 5.14	$ 4.53	$ 4.04

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 04

-Paragraph 20

-Article 9

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 230

-SubTopic 10

-Section 45

-Paragraph 28

-URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3602-108585

Reference 3: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Other Comprehensive Income

-URI http://asc.fasb.org/extlink&oid=6519514

Reference 4: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Net Income

-URI http://asc.fasb.org/extlink&oid=6518256

Reference 5: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 260

-SubTopic 10

-Section 50

-Paragraph 1

-URI http://asc.fasb.org/extlink&oid=6371337&loc=d3e3550-109257

Reference 6: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 944

-SubTopic 225

-Section S99

-Paragraph 1

-Subparagraph (SX 210.7-04.19)

-URI http://asc.fasb.org/extlink&oid=6879464&loc=d3e573970-122913

Reference 7: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 225

-SubTopic 10

-Section S99

-Paragraph 2

-Subparagraph (SX 210.5-03.18)

-URI http://asc.fasb.org/extlink&oid=26872669&loc=d3e20235-122688

Reference 8: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 944

-SubTopic 225

-Section S99

-Paragraph 1

-Subparagraph (SX 210.7-04.22)

-URI http://asc.fasb.org/extlink&oid=6879464&loc=d3e573970-122913

Reference 9: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 220

-SubTopic 10

-Section 45

-Paragraph 6

-URI http://asc.fasb.org/extlink&oid=28358780&loc=d3e565-108580

Reference 10: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 03

-Paragraph 19

-Article 5

+ Details

Quarterly Results - Additional Information (Detail) (USD $)	3 Months Ended
	Mar. 31, 2012 Resulting from an agreement entered into with the United States Department of Health and Human Services, the Secretary of Health and Human Services, and the Centers for Medicare and Medicaid Services	Mar. 31, 2012 Oklahoma Supplemental Hospital Offset Payment Program	Jun. 30, 2013 Implementation of EHR applications	Mar. 31, 2013 Implementation of EHR applications	Jun. 30, 2012 Implementation of EHR applications	Mar. 31, 2012 Implementation of EHR applications	Mar. 31, 2012 Implementation of EHR applications Federal fiscal years 2006 through 2009	Jun. 30, 2012 Reimbursements related to prior years	Dec. 31, 2013 EHR applications	Sep. 30, 2013 EHR applications	Dec. 31, 2012 EHR applications	Sep. 30, 2012 EHR applications	Sep. 30, 2012 Write-off of deferred financing costs	Dec. 31, 2012 Sale of an acute care facility	Dec. 31, 2012 Professional and general liability self-insurance reserves relating to years prior to 2012	Dec. 31, 2013 Professional and general liability self-insurance reserves relating to years prior to 2013	Jun. 30, 2013 Professional and general liability self-insurance reserves relating to years prior to 2013
Quarterly Financial Information [Line Items]
Unfavorable pre-tax reduction			$ 8,900,000	$ 1,100,000	$ 8,000,000	$ 8,300,000	$ 2,400,000						$ 29,200,000
Unfavorable after-tax reduction			4,900,000	327,000	5,000,000	5,100,000							18,100,000
Tax reduction per diluted share	$ 0.19	$ 0.04	$ 0.05	$ 0.01	$ 0.05	$ 0.05		$ 0.03	$ 0.12	$ 0.05	$ 0.06	$ 0.01	$ 0.19	$ 0.17	$ 0.16	$ 0.09	$ 0.38
Favorable pre-tax reduction	30,200,000	7,000,000						5,500,000	19,400,000	8,400,000	8,900,000	2,200,000		26,400,000	27,200,000	15,600,000	65,000,000
Favorable after-tax reduction	18,800,000	4,300,000						3,400,000	11,800,000	5,100,000	5,500,000	1,300,000		16,400,000	15,500,000	9,200,000	37,800,000
Unfavorable after tax impact related to acute care hospital construction						$ 2,700,000

Supplemental Condensed Consolidating Statements of Income (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Condensed Financial Statements, Captions [Line Items]
Net revenues before provision for doubtful accounts									$ 8,411,038	$ 7,688,071	$ 7,356,798
Less: Provision for doubtful accounts									1,127,216	726,671	596,576
Net revenues	1,800,846	1,816,369	1,834,975	1,831,632	1,764,927	1,680,353	1,723,084	1,793,036	7,283,822	6,961,400	6,760,222
Operating charges:
Salaries, wages and benefits									3,604,620	3,440,917	3,326,378
Other operating expenses									1,468,744	1,376,122	1,353,693
Supplies expense									821,089	799,621	805,489
Depreciation and amortization									337,172	302,426	287,211
Lease and rental expense									97,758	94,885	90,323
Transaction costs									0	5,716	0
EHR incentive income									(61,024)	(30,038)	0
Costs related to extinguishment of debt									0	29,170	0
Operating expenses									6,268,359	6,018,819	5,863,094
Income from operations									1,015,463	942,581	897,128
Interest expense, net									146,131	178,918	200,792
Interest (income) expense, affiliate									0	0	0
Equity in net income of consolidated affiliates									0	0	0
Income before income taxes									869,332	763,663	696,336
Provision for income taxes									315,309	274,616	247,466
Net income	133,186	123,099	167,803	129,935	147,660	81,373	117,444	142,570	554,023	489,047	448,870
Less: Income attributable to noncontrolling interests	8,665	8,512	15,962	10,151	12,199	9,556	9,883	13,963	43,290	45,601	50,703
Net income attributable to UHS	124,521	114,587	151,841	119,784	135,461	71,817	107,561	128,607	510,733	443,446	398,167
Parent
Condensed Financial Statements, Captions [Line Items]
Net revenues before provision for doubtful accounts									0	0	0
Less: Provision for doubtful accounts									0	0	0
Net revenues									0	0	0
Operating charges:
Salaries, wages and benefits									0	0	0
Other operating expenses									0	0	200
Supplies expense									0	0	0
Depreciation and amortization									0	0	0
Lease and rental expense									0	0	0
Transaction costs										0
EHR incentive income									0	0
Costs related to extinguishment of debt										29,170
Operating expenses									0	29,170	200
Income from operations									0	(29,170)	(200)
Interest expense, net									139,793	172,467	195,404
Interest (income) expense, affiliate									0	0	0
Equity in net income of consolidated affiliates									(597,020)	(567,906)	(518,797)
Income before income taxes									457,227	366,269	323,193
Provision for income taxes									(53,506)	(77,177)	(74,974)
Net income									510,733	443,446	398,167
Less: Income attributable to noncontrolling interests									0	0	0
Net income attributable to UHS									510,733	443,446	398,167
Guarantors
Condensed Financial Statements, Captions [Line Items]
Net revenues before provision for doubtful accounts									5,658,699	5,152,816	4,917,358
Less: Provision for doubtful accounts									657,106	411,538	340,121
Net revenues									5,001,593	4,741,278	4,577,237
Operating charges:
Salaries, wages and benefits									2,573,205	2,452,187	2,371,961
Other operating expenses									972,170	899,274	923,579
Supplies expense									510,078	496,848	499,200
Depreciation and amortization									236,958	210,867	207,981
Lease and rental expense									62,518	59,596	60,768
Transaction costs										5,716
EHR incentive income									(43,027)	(14,284)
Costs related to extinguishment of debt										0
Operating expenses									4,311,902	4,110,204	4,063,489
Income from operations									689,691	631,074	513,748
Interest expense, net									3,365	3,749	3,212
Interest (income) expense, affiliate									84,640	93,363	87,205
Equity in net income of consolidated affiliates									(141,004)	(141,983)	(157,009)
Income before income taxes									742,690	675,945	580,340
Provision for income taxes									262,346	237,072	198,091
Net income									480,344	438,873	382,249
Less: Income attributable to noncontrolling interests									0	0	0
Net income attributable to UHS									480,344	438,873	382,249
Non Guarantors
Condensed Financial Statements, Captions [Line Items]
Net revenues before provision for doubtful accounts									2,780,983	2,562,781	2,465,916
Less: Provision for doubtful accounts									470,110	315,133	256,455
Net revenues									2,310,873	2,247,648	2,209,461
Operating charges:
Salaries, wages and benefits									1,031,415	988,730	954,417
Other operating expenses									523,382	502,592	454,601
Supplies expense									311,011	302,773	306,289
Depreciation and amortization									100,214	91,559	79,230
Lease and rental expense									37,076	37,071	31,344
Transaction costs										0
EHR incentive income									(17,997)	(15,754)
Costs related to extinguishment of debt										0
Operating expenses									1,985,101	1,906,971	1,825,881
Income from operations									325,772	340,677	383,580
Interest expense, net									2,973	2,702	2,176
Interest (income) expense, affiliate									(84,640)	(93,363)	(87,205)
Equity in net income of consolidated affiliates									0	0	0
Income before income taxes									407,439	431,338	468,609
Provision for income taxes									106,469	114,721	124,349
Net income									300,970	316,617	344,260
Less: Income attributable to noncontrolling interests									43,290	45,601	50,703
Net income attributable to UHS									257,680	271,016	293,557
Consolidating Adjustments
Condensed Financial Statements, Captions [Line Items]
Net revenues before provision for doubtful accounts									(28,644)	(27,526)	(26,476)
Less: Provision for doubtful accounts									0	0	0
Net revenues									(28,644)	(27,526)	(26,476)
Operating charges:
Salaries, wages and benefits									0	0	0
Other operating expenses									(26,808)	(25,744)	(24,687)
Supplies expense									0	0	0
Depreciation and amortization									0	0	0
Lease and rental expense									(1,836)	(1,782)	(1,789)
Transaction costs										0
EHR incentive income									0	0
Costs related to extinguishment of debt										0
Operating expenses									(28,644)	(27,526)	(26,476)
Income from operations									0	0	0
Interest expense, net									0	0	0
Interest (income) expense, affiliate									0	0	0
Equity in net income of consolidated affiliates									738,024	709,889	675,806
Income before income taxes									(738,024)	(709,889)	(675,806)
Provision for income taxes									0	0	0
Net income									(738,024)	(709,889)	(675,806)
Less: Income attributable to noncontrolling interests									0	0	0
Net income attributable to UHS									$ (738,024)	$ (709,889)	$ (675,806)

Supplemental Condensed Consolidating Comprehensive Income (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Comprehensive Income (Loss) [Line Items]
Net income	$ 133,186	$ 123,099	$ 167,803	$ 129,935	$ 147,660	$ 81,373	$ 117,444	$ 142,570	$ 554,023	$ 489,047	$ 448,870
Other comprehensive income (loss):
Unrealized derivative gains (losses) on cash flow hedges									16,963	6,677	(37,477)
Amortization of terminated hedge									(336)	(336)	(336)
Minimum Pension Liability									14,657	4,986	(12,397)
Other comprehensive income (loss) before tax									31,284	11,327	(50,210)
Income tax (benefit) expense related to items of other comprehensive income									11,940	4,306	(19,174)
Total other comprehensive income, net of tax									19,344	7,021	(31,036)
Comprehensive income									573,367	496,068	417,834
Less: Comprehensive income attributable to noncontrolling interests									43,290	45,601	50,703
Comprehensive income attributable to UHS									530,077	450,467	367,131
Parent
Comprehensive Income (Loss) [Line Items]
Net income									510,733	443,446	398,167
Other comprehensive income (loss):
Unrealized derivative gains (losses) on cash flow hedges									16,963	6,677	(37,477)
Amortization of terminated hedge									(336)	(336)	(336)
Minimum Pension Liability									14,657	4,986	(12,397)
Other comprehensive income (loss) before tax									31,284	11,327	(50,210)
Income tax (benefit) expense related to items of other comprehensive income									11,940	4,306	(19,174)
Total other comprehensive income, net of tax									19,344	7,021	(31,036)
Comprehensive income									530,077	450,467	367,131
Less: Comprehensive income attributable to noncontrolling interests									0	0	0
Comprehensive income attributable to UHS									530,077	450,467	367,131
Guarantors
Comprehensive Income (Loss) [Line Items]
Net income									480,344	438,873	382,249
Other comprehensive income (loss):
Unrealized derivative gains (losses) on cash flow hedges									0	0	0
Amortization of terminated hedge									0	0	0
Minimum Pension Liability									14,657	4,986	(12,397)
Other comprehensive income (loss) before tax									14,657	4,986	(12,397)
Income tax (benefit) expense related to items of other comprehensive income									5,670	1,898	(4,691)
Total other comprehensive income, net of tax									8,987	3,088	(7,706)
Comprehensive income									489,331	441,961	374,543
Less: Comprehensive income attributable to noncontrolling interests									0	0	0
Comprehensive income attributable to UHS									489,331	441,961	374,543
Non Guarantors
Comprehensive Income (Loss) [Line Items]
Net income									300,970	316,617	344,260
Other comprehensive income (loss):
Unrealized derivative gains (losses) on cash flow hedges									0	0	0
Amortization of terminated hedge									0	0	0
Minimum Pension Liability									0	0	0
Other comprehensive income (loss) before tax									0	0	0
Income tax (benefit) expense related to items of other comprehensive income									0	0	0
Total other comprehensive income, net of tax									0	0	0
Comprehensive income									300,970	316,617	344,260
Less: Comprehensive income attributable to noncontrolling interests									43,290	45,601	50,703
Comprehensive income attributable to UHS									257,680	271,016	293,557
Consolidating Adjustments
Comprehensive Income (Loss) [Line Items]
Net income									(738,024)	(709,889)	(675,806)
Other comprehensive income (loss):
Unrealized derivative gains (losses) on cash flow hedges									0	0	0
Amortization of terminated hedge									0	0	0
Minimum Pension Liability									(14,657)	(4,986)	12,397
Other comprehensive income (loss) before tax									(14,657)	(4,986)	12,397
Income tax (benefit) expense related to items of other comprehensive income									(5,670)	(1,898)	4,691
Total other comprehensive income, net of tax									(8,987)	(3,088)	7,706
Comprehensive income									(747,011)	(712,977)	(668,100)
Less: Comprehensive income attributable to noncontrolling interests									0	0	0
Comprehensive income attributable to UHS									$ (747,011)	$ (712,977)	$ (668,100)

Supplemental Condensed Consolidating Balance Sheet (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Current assets:
Cash and cash equivalents	$ 17,238	$ 23,471	$ 41,229	$ 29,474
Accounts receivable, net	1,116,961	1,067,197
Supplies	101,781	99,000
Deferred income taxes	119,903	104,461
Other current assets	76,446	87,936
Current assets held for sale	0	25,431
Total current assets	1,432,329	1,407,496
Investments in subsidiaries	0	0
Intercompany receivable	0	0
Intercompany note receivable	0	0
Property and equipment	5,691,902	5,368,345
Less: accumulated depreciation	(2,249,733)	(1,986,110)
Property Equipment, net	3,442,169	3,382,235
Other assets:
Goodwill	3,049,016	3,036,765	2,627,602
Deferred charges	57,881	75,888
Other	330,328	298,459
Total assets	8,311,723	8,200,843	7,665,245
Current liabilities:
Current maturities of long-term debt	99,312	2,589
Accounts payable and accrued liabilities	953,449	889,557
Current liabilities held for sale	0	850
Federal and state taxes	7,127	1,062
Total current liabilities	1,059,888	894,058
Intercompany payable	0	0
Other noncurrent liabilities	284,589	395,355
Long-term debt	3,209,762	3,727,431
Intercompany note payable	0	0
Deferred income taxes	239,148	183,747
Redeemable noncontrolling interests	218,107	234,303
UHS common stockholders' equity	3,249,979	2,713,345
Noncontrolling interest	50,250	52,604
Total equity	3,300,229	2,765,949	2,347,118	2,023,771
Liabilities and Equity, Total	8,311,723	8,200,843
Parent
Current assets:
Cash and cash equivalents	0	0	0	0
Accounts receivable, net	0	7,154
Supplies	0	0
Deferred income taxes	76,719	61,364
Other current assets	0	2,188
Current assets held for sale		0
Total current assets	76,719	70,706
Investments in subsidiaries	6,378,499	5,781,479
Intercompany receivable	226,592	644,105
Intercompany note receivable	0	0
Property and equipment	0	0
Less: accumulated depreciation	0	0
Property Equipment, net	0	0
Other assets:
Goodwill	0	820
Deferred charges	49,866	67,831
Other	8,411	9,645
Total assets	6,740,087	6,574,586
Current liabilities:
Current maturities of long-term debt	97,403	0
Accounts payable and accrued liabilities	28,099	10,985
Current liabilities held for sale		0
Federal and state taxes	4,963	0
Total current liabilities	130,465	10,985
Intercompany payable	0	0
Other noncurrent liabilities	7,591	46,048
Long-term debt	3,168,819	3,676,940
Intercompany note payable	0	0
Deferred income taxes	183,233	127,268
Redeemable noncontrolling interests	0	0
UHS common stockholders' equity	3,249,979	2,713,345
Noncontrolling interest	0	0
Total equity	3,249,979	2,713,345
Liabilities and Equity, Total	6,740,087	6,574,586
Guarantors
Current assets:
Cash and cash equivalents	7,990	11,949	33,221	21,385
Accounts receivable, net	799,898	741,983
Supplies	63,562	61,100
Deferred income taxes	43,184	43,555
Other current assets	63,786	75,117
Current assets held for sale		0
Total current assets	978,420	933,704
Investments in subsidiaries	1,476,911	1,326,920
Intercompany receivable	0	0
Intercompany note receivable	0	0
Property and equipment	4,093,914	3,867,471
Less: accumulated depreciation	(1,478,758)	(1,288,975)
Property Equipment, net	2,615,156	2,578,496
Other assets:
Goodwill	2,552,190	2,554,531
Deferred charges	5,577	5,839
Other	251,365	209,558
Total assets	7,879,619	7,609,048
Current liabilities:
Current maturities of long-term debt	916	990
Accounts payable and accrued liabilities	837,354	740,484
Current liabilities held for sale		0
Federal and state taxes	2,164	900
Total current liabilities	840,434	742,374
Intercompany payable	758,003	1,004,643
Other noncurrent liabilities	199,104	243,478
Long-term debt	5,337	5,372
Intercompany note payable	982,568	1,007,453
Deferred income taxes	55,915	56,801
Redeemable noncontrolling interests	0	0
UHS common stockholders' equity	5,038,258	4,548,927
Noncontrolling interest	0	0
Total equity	5,038,258	4,548,927
Liabilities and Equity, Total	7,879,619	7,609,048
Non Guarantors
Current assets:
Cash and cash equivalents	9,248	11,522	8,008	8,089
Accounts receivable, net	317,063	318,060
Supplies	38,219	37,900
Deferred income taxes	0	322
Other current assets	12,660	10,631
Current assets held for sale		25,431
Total current assets	377,190	403,866
Investments in subsidiaries	0	0
Intercompany receivable	531,411	360,538
Intercompany note receivable	982,568	1,007,453
Property and equipment	1,597,988	1,500,874
Less: accumulated depreciation	(770,975)	(697,135)
Property Equipment, net	827,013	803,739
Other assets:
Goodwill	496,826	481,414
Deferred charges	2,438	2,218
Other	70,552	79,256
Total assets	3,287,998	3,138,484
Current liabilities:
Current maturities of long-term debt	993	1,599
Accounts payable and accrued liabilities	87,996	138,088
Current liabilities held for sale		850
Federal and state taxes	0	620
Total current liabilities	88,989	141,157
Intercompany payable	0	0
Other noncurrent liabilities	77,894	105,829
Long-term debt	35,606	45,119
Intercompany note payable	0	0
Deferred income taxes	0	0
Redeemable noncontrolling interests	218,107	234,303
UHS common stockholders' equity	2,817,152	2,559,472
Noncontrolling interest	50,250	52,604
Total equity	2,867,402	2,612,076
Liabilities and Equity, Total	3,287,998	3,138,484
Consolidating Adjustments
Current assets:
Cash and cash equivalents	0	0	0	0
Accounts receivable, net	0	0
Supplies	0	0
Deferred income taxes	0	(780)
Other current assets	0	0
Current assets held for sale		0
Total current assets	0	(780)
Investments in subsidiaries	(7,855,410)	(7,108,399)
Intercompany receivable	(758,003)	(1,004,643)
Intercompany note receivable	(982,568)	(1,007,453)
Property and equipment	0	0
Less: accumulated depreciation	0	0
Property Equipment, net	0	0
Other assets:
Goodwill	0	0
Deferred charges	0	0
Other	0	0
Total assets	(9,595,981)	(9,121,275)
Current liabilities:
Current maturities of long-term debt	0	0
Accounts payable and accrued liabilities	0	0
Current liabilities held for sale		0
Federal and state taxes	0	(458)
Total current liabilities	0	(458)
Intercompany payable	(758,003)	(1,004,643)
Other noncurrent liabilities	0	0
Long-term debt	0	0
Intercompany note payable	(982,568)	(1,007,453)
Deferred income taxes	0	(322)
Redeemable noncontrolling interests	0	0
UHS common stockholders' equity	(7,855,410)	(7,108,399)
Noncontrolling interest	0	0
Total equity	(7,855,410)	(7,108,399)
Liabilities and Equity, Total	$ (9,595,981)	$ (9,121,275)

Supplemental Condensed Consolidating Statements of Cash flows (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Condensed Financial Statements, Captions [Line Items]
Net cash (used in) provided by operating activities	$ 884,241	$ 799,231	$ 710,683
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(358,493)	(363,192)	(285,682)
Acquisition of property and businesses	(12,636)	(527,847)	(29,466)
Proceeds received from sale of assets and businesses	37,482	149,311	67,592
Costs incurred for purchase and development of electronic health records application	(49,811)	(54,362)	(38,249)
Return of deposit on terminated purchase agreement	0	6,500	0
Net cash provided by (used in) investing activities	(383,458)	(789,590)	(285,805)
Cash Flows from Financing Activities:
Reduction of long-term debt	(440,224)	(849,647)	(381,517)
Additional borrowings	15,761	913,500	98,100
Financing costs	(231)	(8,283)	(23,608)
Repurchase of common shares	(27,201)	(19,154)	(60,482)
Dividends paid	(19,621)	(58,395)	(19,466)
Issuance of common stock	5,708	5,435	4,779
Excess income tax benefits related to stock based compensation	20,121	16,040	7,568
Profit distributions to noncontrolling interests	(61,329)	(26,895)	(38,497)
Changes in intercompany balances with affiliates, net	0	0	0
Net cash (used in) provided by financing activities	(507,016)	(27,399)	(413,123)
Increase (decrease) in cash and cash equivalents	(6,233)	(17,758)	11,755
Cash and cash equivalents, beginning of period	23,471	41,229	29,474
Cash and cash equivalents, end of period	17,238	23,471	41,229
Parent
Condensed Financial Statements, Captions [Line Items]
Net cash (used in) provided by operating activities	17,946	(37,648)	(12,558)
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	0	0	0
Acquisition of property and businesses	0	0	0
Proceeds received from sale of assets and businesses	0	0	0
Costs incurred for purchase and development of electronic health records application	0	0	0
Return of deposit on terminated purchase agreement		6,500
Net cash provided by (used in) investing activities	0	6,500	0
Cash Flows from Financing Activities:
Reduction of long-term debt	(429,996)	(843,002)	(382,060)
Additional borrowings	15,761	913,500	98,100
Financing costs	(231)	(8,283)	(23,608)
Repurchase of common shares	(27,201)	(19,154)	(60,482)
Dividends paid	(19,621)	(58,395)	(19,466)
Issuance of common stock	5,708	5,435	4,779
Excess income tax benefits related to stock based compensation	20,121	16,040	7,568
Profit distributions to noncontrolling interests	0	0	0
Changes in intercompany balances with affiliates, net	417,513	25,007	387,727
Net cash (used in) provided by financing activities	(17,946)	31,148	12,558
Increase (decrease) in cash and cash equivalents	0	0	0
Cash and cash equivalents, beginning of period	0	0	0
Cash and cash equivalents, end of period	0	0	0
Guarantors
Condensed Financial Statements, Captions [Line Items]
Net cash (used in) provided by operating activities	587,083	594,606	518,462
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(269,419)	(312,190)	(226,848)
Acquisition of property and businesses	(8,094)	(513,596)	0
Proceeds received from sale of assets and businesses	7,916	142,667	0
Costs incurred for purchase and development of electronic health records application	(49,811)	(54,362)	(38,249)
Return of deposit on terminated purchase agreement		0
Net cash provided by (used in) investing activities	(319,408)	(737,481)	(265,097)
Cash Flows from Financing Activities:
Reduction of long-term debt	(109)	0	(1,442)
Additional borrowings	0	1,613	0
Financing costs	0	0	0
Repurchase of common shares	0	0	0
Dividends paid	0	0	0
Issuance of common stock	0	0	0
Excess income tax benefits related to stock based compensation	0	0	0
Profit distributions to noncontrolling interests	0	0	0
Changes in intercompany balances with affiliates, net	(271,525)	119,990	(240,087)
Net cash (used in) provided by financing activities	(271,634)	121,603	(241,529)
Increase (decrease) in cash and cash equivalents	(3,959)	(21,272)	11,836
Cash and cash equivalents, beginning of period	11,949	33,221	21,385
Cash and cash equivalents, end of period	7,990	11,949	33,221
Non Guarantors
Condensed Financial Statements, Captions [Line Items]
Net cash (used in) provided by operating activities	279,212	242,273	204,779
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(89,074)	(51,002)	(58,834)
Acquisition of property and businesses	(4,542)	(14,251)	(29,466)
Proceeds received from sale of assets and businesses	29,566	6,644	67,592
Costs incurred for purchase and development of electronic health records application	0	0	0
Return of deposit on terminated purchase agreement		0
Net cash provided by (used in) investing activities	(64,050)	(58,609)	(20,708)
Cash Flows from Financing Activities:
Reduction of long-term debt	(10,119)	(8,258)	0
Additional borrowings	0	0	1,985
Financing costs	0	0	0
Repurchase of common shares	0	0	0
Dividends paid	0	0	0
Issuance of common stock	0	0	0
Excess income tax benefits related to stock based compensation	0	0	0
Profit distributions to noncontrolling interests	(61,329)	(26,895)	(38,497)
Changes in intercompany balances with affiliates, net	(145,988)	(144,997)	(147,640)
Net cash (used in) provided by financing activities	(217,436)	(180,150)	(184,152)
Increase (decrease) in cash and cash equivalents	(2,274)	3,514	(81)
Cash and cash equivalents, beginning of period	11,522	8,008	8,089
Cash and cash equivalents, end of period	9,248	11,522	8,008
Consolidating Adjustments
Condensed Financial Statements, Captions [Line Items]
Net cash (used in) provided by operating activities	0	0	0
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	0	0	0
Acquisition of property and businesses	0	0	0
Proceeds received from sale of assets and businesses	0	0	0
Costs incurred for purchase and development of electronic health records application	0	0	0
Return of deposit on terminated purchase agreement		0
Net cash provided by (used in) investing activities	0	0	0
Cash Flows from Financing Activities:
Reduction of long-term debt	0	1,613	1,985
Additional borrowings	0	(1,613)	(1,985)
Financing costs	0	0	0
Repurchase of common shares	0	0	0
Dividends paid	0	0	0
Issuance of common stock	0	0	0
Excess income tax benefits related to stock based compensation	0	0	0
Profit distributions to noncontrolling interests	0	0	0
Changes in intercompany balances with affiliates, net	0	0	0
Net cash (used in) provided by financing activities	0	0	0
Increase (decrease) in cash and cash equivalents	0	0	0
Cash and cash equivalents, beginning of period	0	0	0
Cash and cash equivalents, end of period	$ 0	$ 0	$ 0

Valuation and Qualifying Accounts (Detail) (USD $)
In Thousands, unless otherwise specified

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Allowance for Doubtful Accounts Receivable

Valuation and Qualifying Accounts Disclosure [Line Items]

Balance at beginning of period

$ 311,387

$ 253,405

^[1]

$ 248,622

^[1]

Charges to costs and expenses

1,127,216

726,671

613,619

^[1]

Acquisitions of business

5,632

Write-off of uncollectible accounts

(1,043,568)

(674,321)

(608,836)

^[1]

Balance at end of period

395,035

311,387

253,405

^[1]

Valuation Allowance for Deferred Tax Assets

Valuation and Qualifying Accounts Disclosure [Line Items]

Balance at beginning of period

44,511

42,143

32,352

Charges to costs and expenses

2,330

2,368

10,904

Write-off of uncollectible accounts

(1,113)

Balance at end of period

$ 46,841

$ 44,511

$ 42,143

[1]	Included in the charges to costs and expenses in 2011 is $17.0 million related to facilities that were divested or recorded as held for sale during 2012.

Schedule of Weighted Average Remaining Contractual Life for Options Outstanding and Weighted Average Exercise Price Per Share for Exercisable Options (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2013
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Weighted average forfeiture rate	10.80%

Lease Commitments - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013 Facility	Dec. 31, 2012	Dec. 31, 2011
Leases Disclosure [Line Items]
Number of hospital facilities	4
Additional capital lease obligations incurred	$ 0	$ 0	$ 0

Schedule of Measurement Dates (Detail)	12 Months Ended
Schedule of Measurement Dates (Detail)	Dec. 31, 2013	Dec. 31, 2012
Benefit Obligation
Defined Benefit Plan Disclosure [Line Items]
Measurement Dates	12/31/2013	12/31/2012
Fair Value Of Plan Assets
Defined Benefit Plan Disclosure [Line Items]
Measurement Dates	12/31/2013	12/31/2012

Supplemental Condensed Consolidating Financial Information - Additional Information (Detail) (Guarantors)	Dec. 31, 2013
Guarantors
Supplementary Information [Line Items]
Percentage of ownership interests	100.00%

Valuation and Qualifying Accounts (Parenthetical) (Detail) (USD $) In Millions, unless otherwise specified	12 Months Ended
	Dec. 31, 2011
Valuation and Qualifying Accounts Disclosure [Line Items]
Cost and expenses related to facilities	$ 17.0