Net Revenues and Accounts Receivable (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Segment Reporting Information [Line Items]
Net revenues	$ 487,505	$ 415,591
Percentage variance	17.30%
Home Health [Member]
Segment Reporting Information [Line Items]
Net revenues	256,000	236,100
Hospice [Member]
Segment Reporting Information [Line Items]
Net revenues	174,400	179,500
Medicare [Member]
Segment Reporting Information [Line Items]
Net revenues	372,000	360,400
Percentage variance	3.20%
Medicare [Member] | Home Health [Member]
Segment Reporting Information [Line Items]
Net revenues	208,800	193,100
Percentage variance	8.10%
Medicare [Member] | Hospice [Member]
Segment Reporting Information [Line Items]
Net revenues	163,200	167,300
Percentage variance	(2.40%)
Medicaid and Local Government [Member]
Segment Reporting Information [Line Items]
Net revenues	71,100	18,200
Percentage variance	289.30%
Medicaid and Local Government [Member] | Home Health [Member]
Segment Reporting Information [Line Items]
Net revenues	8,500	11,200
Medicaid and Local Government [Member] | Hospice [Member]
Segment Reporting Information [Line Items]
Net revenues	6,200	7,000
Commercial Insurance and Other [Member]
Segment Reporting Information [Line Items]
Net revenues	44,400	37,000
Percentage variance	20.20%
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment Reporting Information [Line Items]
Net revenues	15,600	14,300
Percentage variance	9.40%
Commercial Insurance and Other [Member] | Commercial Insurance Other [Member]
Segment Reporting Information [Line Items]
Net revenues	28,800	22,700
Percentage variance	27.00%
Commercial Insurance and Other [Member] | Home Health [Member] | Paid at Episodic Rates [Member]
Segment Reporting Information [Line Items]
Net revenues	15,600	14,300
Commercial Insurance and Other [Member] | Home Health [Member] | Commercial Insurance Other [Member]
Segment Reporting Information [Line Items]
Net revenues	23,100	17,500
Commercial Insurance and Other [Member] | Hospice [Member] | Paid at Episodic Rates [Member]
Segment Reporting Information [Line Items]
Net revenues	0	0
Commercial Insurance and Other [Member] | Hospice [Member] | Commercial Insurance Other [Member]
Segment Reporting Information [Line Items]
Net revenues	$ 5,000	$ 5,200