Cost Savings Initiatives, Acquisition and Integration Activities and Legal Settlements (Details Textual) (USD $)	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	Dec. 31, 2010
Segment Reporting Information [Line Items]
Charge	$ 24,955,000	$ 1,699,000	$ 744,000	$ 141,000	$ 201,000	$ 53,000	$ 25,000	$ 5,391,000	$ 27,539,000	$ 5,670,000	$ 49,138,000
Restructuring reserve	16,425,000				2,696,000				16,425,000	2,696,000	38,379,000	19,377,000
Non-cash compensation expense											400,000
Cost Savings Initiative [Member]
Segment Reporting Information [Line Items]
Charge									8,742,000
Restructuring reserve	6,722,000				1,685,000				6,722,000	1,685,000	8,671,000	2,893,000
Acquisition Integration [Member]
Segment Reporting Information [Line Items]
Charge									18,797,000	(989,000)	7,879,000
Restructuring reserve	9,703,000				1,011,000				9,703,000	1,011,000	3,708,000	3,984,000
Legal Settlements [Member]
Segment Reporting Information [Line Items]
Charge									0	4,958,000	26,000,000
Restructuring reserve	0				0				0	0	26,000,000	12,500,000
2011 and 2012 initiatives [Member] | Cost Savings Initiative [Member]
Segment Reporting Information [Line Items]
Charge									100,000	1,701,000	15,259,000
2011 and 2012 initiatives [Member] | Home Health [Member] | Cost Savings Initiative [Member]
Segment Reporting Information [Line Items]
Number of branches closed, consolidated or divested											46
2011 and 2012 initiatives [Member] | Hospice [Member] | Cost Savings Initiative [Member]
Segment Reporting Information [Line Items]
Number of branches closed, consolidated or divested											13
2013 initiatives [Member] | Cost Savings Initiative [Member]
Segment Reporting Information [Line Items]
Charge									$ 8,700,000
Number of branches closed, consolidated or divested									77