Net Revenues and Accounts Receivable (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2013	Mar. 31, 2012
Segment Reporting Information [Line Items]
Net revenues	$ 415,591	$ 435,652
Percentage variance	(4.60%)
Home Health [Member]
Segment Reporting Information [Line Items]
Net revenues	236,100	240,000
Hospice [Member]
Segment Reporting Information [Line Items]
Net revenues	179,500	195,700
Medicare [Member]
Segment Reporting Information [Line Items]
Net revenues	360,400	372,600
Percentage variance	(3.30%)
Medicare [Member] | Home Health [Member]
Segment Reporting Information [Line Items]
Net revenues	193,100	190,600
Percentage variance	1.30%
Medicare [Member] | Hospice [Member]
Segment Reporting Information [Line Items]
Net revenues	167,300	182,000
Percentage variance	(8.10%)
Medicaid and Local Government [Member]
Segment Reporting Information [Line Items]
Net revenues	18,200	19,500
Percentage variance	(6.10%)
Medicaid and Local Government [Member] | Home Health [Member]
Segment Reporting Information [Line Items]
Net revenues	11,200	11,900
Medicaid and Local Government [Member] | Hospice [Member]
Segment Reporting Information [Line Items]
Net revenues	7,000	7,600
Commercial Insurance and Other [Member]
Segment Reporting Information [Line Items]
Net revenues	37,000	43,600
Percentage variance	(15.30%)
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment Reporting Information [Line Items]
Net revenues	14,300	20,000
Percentage variance	(28.60%)
Commercial Insurance and Other [Member] | Commercial Insurance Other [Member]
Segment Reporting Information [Line Items]
Net revenues	22,700	23,600
Percentage variance	(3.90%)
Commercial Insurance and Other [Member] | Home Health [Member] | Paid at Episodic Rates [Member]
Segment Reporting Information [Line Items]
Net revenues	14,300	20,000
Commercial Insurance and Other [Member] | Home Health [Member] | Commercial Insurance Other [Member]
Segment Reporting Information [Line Items]
Net revenues	17,500	17,500
Commercial Insurance and Other [Member] | Hospice [Member] | Paid at Episodic Rates [Member]
Segment Reporting Information [Line Items]
Net revenues	0	0
Commercial Insurance and Other [Member] | Hospice [Member] | Commercial Insurance Other [Member]
Segment Reporting Information [Line Items]
Net revenues	$ 5,200	$ 6,100