Consolidated Statements of Cash Flows (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
OPERATING ACTIVITIES:
Net (loss) income	$ (598,507)	$ 27,680	$ (449,884)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	20,110	26,580	30,140
Amortization of debt issuance costs	14,715	13,300	12,704
Write off of debt issuance cost	16,085	461	3,559
Provision for doubtful accounts	6,730	4,066	8,541
Equity-based compensation expense	8,210	7,645	7,548
Windfall tax benefits associated with equity-based compensation	(119)	(88)	(192)
Goodwill, intangibles and other long-lived asset impairment	610,436	19,132	643,305
(Gain) loss on sale of assets and businesses, net	0	(8,014)	(12,536)
Equity in net (loss) earnings of CareCentrix, including gain on sale, net of tax	0	2,301	(68,381)
Deferred income tax (benefit) expense	(36,660)	23,513	(86,012)
Changes in assets and liabilities, net of effects from acquisitions and dispositions:
Accounts receivable	910	34,882	(39,542)
Prepaid expenses and other current assets	(17,966)	(15,447)	10,467
Accounts payable	(4,161)	832	(2,949)
Payroll and related taxes	(1,289)	3,275	(2,136)
Deferred revenue	(3,719)	3,330	(2,273)
Medicare liabilities	(3,228)	4,142	(8,170)
Obligations under insurance programs	12,681	1,560	(6,923)
Accrued nursing home costs	1,043	(5,795)	(18)
Other accrued expenses	5,836	(23,323)	(31,642)
Other, net	5,998	5,936	(465)
Net cash provided by operating activities	37,105	125,968	5,141
INVESTING ACTIVITIES:
Purchase of fixed assets	(19,075)	(11,779)	(19,231)
Proceeds from sale of businesses, net of cash transferred	508	9,220	146,315
Proceeds from sale of assets	203	0	0
Acquisition of businesses, net of cash acquired	(359,435)	(22,335)	(320)
Net cash (used in) provided by investing activities	(377,799)	(24,894)	126,764
FINANCING ACTIVITIES:
Proceeds from issuance of common stock	3,231	3,980	7,901
Windfall tax benefits associated with equity-based compensation	119	88	192
Proceeds from issuance of debt	817,525	0	0
Borrowings under revolving credit facility	27,000	0	0
Payments of contingent consideration accrued at acquisition date	(1,675)	0	0
Repayment of long-term debt	(610,182)	(52,943)	(63,438)
Repurchase of common stock	0	(4,974)	0
Debt issuance costs	(15,187)	(4,125)	(15,460)
Minority interest capital contribution	1,600	0	0
Distribution to minority interests	(750)	(825)	(673)
Other	(1,082)	(135)	(267)
Net cash (used in) provided by financing activities	220,599	(58,934)	(71,745)
Net change in cash and cash equivalents	(120,095)	42,140	60,160
Cash and cash equivalents at beginning of period	207,052	164,912	104,752
Cash and cash equivalents at end of period	86,957	207,052	164,912
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION:
Interest paid	77,898	78,783	78,639
Income taxes paid	$ 1,057	$ 4,375	$ 38,067