Net Revenues and Accounts Receivable (Details Textual) (USD $)			12 Months Ended				3 Months Ended	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2013 Medicare Cap Year 2013 [Member]	Dec. 31, 2013 Medicare Cap Year 2014 [Member]	Dec. 31, 2013 Prior Year Medicare Cap Settlement [Member]	Dec. 31, 2012 Prior Year Medicare Cap Settlement [Member]	Sep. 30, 2013 Home Health [Member] PRRB Appeal [Member]	Dec. 31, 2013 Home Health [Member] PRRB Appeal [Member]	Dec. 31, 2013 Hospice [Member]	Dec. 31, 2012 Hospice [Member]	Dec. 31, 2011 Hospice [Member]	Dec. 31, 2013 Hospice [Member] Eligibility Review [Member]	Dec. 31, 2012 Hospice [Member] Eligibility Review [Member]
Schedule of Health Care Revenue Adjustment [Line Items]
Medicare Hospice Cap (income) expense			$ 1,900,000	$ 200,000	$ (6,100,000)	$ (1,500,000)			$ (4,600,000)	$ 4,400,000	$ 4,300,000
Hospice programs exceeding Medicare Payment Cap			5	2					2
Medicare Hospice Cap liabilities									6,500,000	15,900,000
Commercials Insurance self pay accounts receivables related to patient	2,400,000	1,700,000
Patient service revenue adjustments							(4,000,000)	(4,000,000)				12,000,000	4,900,000
Allowance for credit losses	$ 0	$ 0