Business Segment Information (Details) (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 net revenues by major payer source
Total net revenues	$ 486,137	$ 410,492	$ 414,424	$ 415,591	$ 425,017	$ 424,444	$ 427,691	$ 435,652	$ 1,726,644	$ 1,712,804	$ 1,798,778
Medicare [Member]
Segment net revenues by major payer source
Total net revenues									1,455,200	1,464,600	1,528,300
Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues									116,600	74,400	83,100
Commercial Insurance and Other [Member]
Segment net revenues by major payer source
Total net revenues									154,800	173,800	187,400
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues									59,600	85,200	77,700
Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues									95,200	88,600	109,700
Home Health [Member]
Segment net revenues by major payer source
Total net revenues									965,800	948,000	1,012,600
Home Health [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues									787,300	749,000	799,200
Home Health [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues									43,800	46,800	52,300
Home Health [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues									59,600	85,200	77,700
Home Health [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues									75,100	67,000	83,400
Hospice [Member]
Segment net revenues by major payer source
Total net revenues									715,200	764,800	786,200
Hospice [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues									667,900	715,500	729,100
Hospice [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues									28,300	27,700	30,800
Hospice [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues									0	0	0
Hospice [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues									19,000	21,600	26,300
Community Care [Member]
Segment net revenues by major payer source
Total net revenues									45,600	0	0
Community Care [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues									0	0	0
Community Care [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues									44,500	0	0
Community Care [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues									0	0	0
Community Care [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues									$ 1,100	$ 0	$ 0