Identifiable Intangible Assets and Goodwill (Details) (USD $) In Thousands, unless otherwise specified																																									12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2013 Home Health [Member]	Dec. 31, 2012 Home Health [Member]	Dec. 31, 2013 Hospice [Member]	Dec. 31, 2012 Hospice [Member]	Dec. 31, 2013 Community Care [Member]	Dec. 31, 2012 Community Care [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member] Home Health [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member] Home Health [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member] Hospice [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member] Hospice [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member] Community Care [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member] Community Care [Member]	Dec. 31, 2013 Covenants not to compete [Member]	Dec. 31, 2012 Covenants not to compete [Member]	Dec. 31, 2013 Covenants not to compete [Member] Home Health [Member]	Dec. 31, 2012 Covenants not to compete [Member] Home Health [Member]	Dec. 31, 2013 Covenants not to compete [Member] Hospice [Member]	Dec. 31, 2012 Covenants not to compete [Member] Hospice [Member]	Dec. 31, 2013 Covenants not to compete [Member] Community Care [Member]	Dec. 31, 2012 Covenants not to compete [Member] Community Care [Member]	Dec. 31, 2013 Customer Relationships [Member]	Dec. 31, 2012 Customer Relationships [Member]	Dec. 31, 2013 Customer Relationships [Member] Home Health [Member]	Dec. 31, 2012 Customer Relationships [Member] Home Health [Member]	Dec. 31, 2013 Customer Relationships [Member] Hospice [Member]	Dec. 31, 2012 Customer Relationships [Member] Hospice [Member]	Dec. 31, 2013 Customer Relationships [Member] Community Care [Member]	Dec. 31, 2012 Customer Relationships [Member] Community Care [Member]	Dec. 31, 2013 Trade Names [Member]	Dec. 31, 2012 Trade Names [Member]	Dec. 31, 2013 Trade Names [Member] Home Health [Member]	Dec. 31, 2012 Trade Names [Member] Home Health [Member]	Dec. 31, 2013 Trade Names [Member] Hospice [Member]	Dec. 31, 2012 Trade Names [Member] Hospice [Member]	Dec. 31, 2013 Trade Names [Member] Community Care [Member]	Dec. 31, 2012 Trade Names [Member] Community Care [Member]	Dec. 31, 2013 Maximum [Member] Covenants not to compete [Member]	Dec. 31, 2013 Maximum [Member] Customer Relationships [Member]	Dec. 31, 2013 Maximum [Member] Trade Names [Member]	Dec. 31, 2013 Minimum [Member] Covenants not to compete [Member]	Dec. 31, 2013 Minimum [Member] Customer Relationships [Member]	Dec. 31, 2013 Minimum [Member] Trade Names [Member]
Amortized intangible assets:
Finite-Lived Intangible Assets, Gross																	$ 19,369	$ 17,352	$ 2,157	$ 1,667	$ 16,183	$ 15,685	$ 1,029	$ 0	$ 28,106	$ 28,106	$ 27,196	$ 27,196	$ 910	$ 910	$ 0	$ 0	$ 48,717	$ 34,945	$ 19,267	$ 18,215	$ 17,528	$ 16,730	$ 11,922	$ 0
Less: accumulated amortization																	(17,364)	(15,562)	(1,553)	(1,449)	(15,720)	(14,113)	(91)	0	(20,479)	(18,041)	(19,998)	(17,651)	(481)	(390)	0	0	(15,982)	(15,402)	(11,992)	(11,794)	(3,763)	(3,608)	(227)	0
Finite Lived Intangible Assets, Accumulated Impairment																									(26)	(27)	(26)	(27)	0	0	0	0	(19,543)	(19,543)	(6,421)	(6,421)	(13,122)	(13,122)	0	0
Finite-Lived Intangible Assets, Net	22,798	11,828	8,630	9,736	1,535	2,092	12,633	0									2,005	1,790	604	218	463	1,572	938	0	7,601	10,038	7,172	9,518	429	520	0	0	13,192	0	854	0	643	0	11,695	0
Finite-Lived Intangible Asset, useful life																																									5 years	10 years	10 years	2 years	5 years	5 years
Indefinite-lived intangible assets:
Indefinite-Lived Intangible Assets									384,955	326,976	245,545	225,227	113,399	101,749	26,011	0
Indefinite Lived Intangible Assets, Accumulated Impairment									(151,471)	(145,191)	(144,672)	(144,672)	(6,799)	(519)	0	0
Indefinite Lived Intangible Assets, Net									233,484	181,785	100,873	80,555	106,600	101,230	26,011	0
Total identifiable intangible assets	$ 256,282	$ 193,613	$ 109,503	$ 90,291	$ 108,135	$ 103,322	$ 38,644	$ 0