Net Revenues and Accounts Receivable (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended		9 Months Ended
	Sep. 30, 2012	Sep. 30, 2011	Sep. 30, 2012	Sep. 30, 2011
Net revenues by major payer classification
Net revenues	$ 424,444	$ 449,748	$ 1,287,787	$ 1,349,569
Percentage variance	(5.60%)		(4.60%)
Home Health [Member]
Net revenues by major payer classification
Net revenues	234,700	253,200	710,300	763,600
Hospice [Member]
Net revenues by major payer classification
Net revenues	189,700	196,500	577,500	586,000
Medicare [Member]
Net revenues by major payer classification
Net revenues	362,400	382,300	1,100,700	1,144,600
Percentage variance	(5.20%)		(3.80%)
Medicare [Member] | Home Health [Member]
Net revenues by major payer classification
Net revenues	185,000	200,300	561,700	601,600
Percentage variance	(7.60%)		(6.60%)
Medicare [Member] | Hospice [Member]
Net revenues by major payer classification
Net revenues	177,400	182,000	539,000	543,000
Percentage variance	(2.50%)		(0.70%)
Medicaid and Local Government [Member]
Net revenues by major payer classification
Net revenues	19,100	21,200	56,900	63,200
Percentage variance	(9.70%)		(10.00%)
Medicaid and Local Government [Member] | Home Health [Member]
Net revenues by major payer classification
Net revenues	12,200	13,200	35,700	39,800
Medicaid and Local Government [Member] | Hospice [Member]
Net revenues by major payer classification
Net revenues	6,900	8,000	21,200	23,400
Commercial Insurance and Other [Member]
Net revenues by major payer classification
Net revenues	$ 42,900	$ 46,200	$ 130,200	$ 141,800
Percentage variance	(7.30%)		(8.20%)
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Net revenues by major payer classification
Percentage variance	10.90%		8.00%
Commercial Insurance and Other [Member] | Other [Member]
Net revenues by major payer classification
Percentage variance	(20.40%)		(19.40%)