Business Segment Information (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2013	Mar. 31, 2012
Segment net revenues by major payer source
Total net revenues	$ 415,591	$ 435,652
Medicare [Member]
Segment net revenues by major payer source
Total net revenues	360,400	372,600
Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	18,200	19,500
Commercial Insurance and Other [Member]
Segment net revenues by major payer source
Total net revenues	37,000	43,600
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	14,300	20,000
Commercial Insurance and Other [Member] | Commercial Insurance Other [Member]
Segment net revenues by major payer source
Total net revenues	22,700	23,600
Home Health [Member]
Segment net revenues by major payer source
Total net revenues	236,100	240,000
Home Health [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues	193,100	190,600
Home Health [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	11,200	11,900
Home Health [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	14,300	20,000
Home Health [Member] | Commercial Insurance and Other [Member] | Commercial Insurance Other [Member]
Segment net revenues by major payer source
Total net revenues	17,500	17,500
Hospice [Member]
Segment net revenues by major payer source
Total net revenues	179,500	195,700
Hospice [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues	167,300	182,000
Hospice [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	7,000	7,600
Hospice [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	0	0
Hospice [Member] | Commercial Insurance and Other [Member] | Commercial Insurance Other [Member]
Segment net revenues by major payer source
Total net revenues	$ 5,200	$ 6,100