Identifiable Intangible Assets and Goodwill (Details) (USD $) In Thousands, unless otherwise specified																																									3 Months Ended
	Mar. 31, 2014	Dec. 31, 2013	Mar. 31, 2014 Home Health [Member]	Dec. 31, 2013 Home Health [Member]	Mar. 31, 2014 Hospice [Member]	Dec. 31, 2013 Hospice [Member]	Mar. 31, 2014 Community Care [Member]	Dec. 31, 2013 Community Care [Member]	Mar. 31, 2014 Medicare licenses and certificates of need [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member]	Mar. 31, 2014 Medicare licenses and certificates of need [Member] Home Health [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member] Home Health [Member]	Mar. 31, 2014 Medicare licenses and certificates of need [Member] Hospice [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member] Hospice [Member]	Mar. 31, 2014 Medicare licenses and certificates of need [Member] Community Care [Member]	Dec. 31, 2013 Medicare licenses and certificates of need [Member] Community Care [Member]	Mar. 31, 2014 Covenants not to compete [Member]	Dec. 31, 2013 Covenants not to compete [Member]	Mar. 31, 2014 Covenants not to compete [Member] Home Health [Member]	Dec. 31, 2013 Covenants not to compete [Member] Home Health [Member]	Mar. 31, 2014 Covenants not to compete [Member] Hospice [Member]	Dec. 31, 2013 Covenants not to compete [Member] Hospice [Member]	Mar. 31, 2014 Covenants not to compete [Member] Community Care [Member]	Dec. 31, 2013 Covenants not to compete [Member] Community Care [Member]	Mar. 31, 2014 Customer Relationships [Member]	Dec. 31, 2013 Customer Relationships [Member]	Mar. 31, 2014 Customer Relationships [Member] Home Health [Member]	Dec. 31, 2013 Customer Relationships [Member] Home Health [Member]	Mar. 31, 2014 Customer Relationships [Member] Hospice [Member]	Dec. 31, 2013 Customer Relationships [Member] Hospice [Member]	Mar. 31, 2014 Customer Relationships [Member] Community Care [Member]	Dec. 31, 2013 Customer Relationships [Member] Community Care [Member]	Mar. 31, 2014 Trade Names [Member]	Dec. 31, 2013 Trade Names [Member]	Mar. 31, 2014 Trade Names [Member] Home Health [Member]	Dec. 31, 2013 Trade Names [Member] Home Health [Member]	Mar. 31, 2014 Trade Names [Member] Hospice [Member]	Dec. 31, 2013 Trade Names [Member] Hospice [Member]	Mar. 31, 2014 Trade Names [Member] Community Care [Member]	Dec. 31, 2013 Trade Names [Member] Community Care [Member]	Mar. 31, 2014 Maximum [Member] Covenants not to compete [Member]	Mar. 31, 2014 Maximum [Member] Customer Relationships [Member]	Mar. 31, 2014 Maximum [Member] Trade Names [Member]	Mar. 31, 2014 Minimum [Member] Covenants not to compete [Member]	Mar. 31, 2014 Minimum [Member] Customer Relationships [Member]	Mar. 31, 2014 Minimum [Member] Trade Names [Member]
Amortized intangible assets:
Finite-Lived Intangible Assets, Gross																	$ 19,369	$ 19,369	$ 2,157	$ 2,157	$ 16,183	$ 16,183	$ 1,029	$ 1,029	$ 28,106	$ 28,106	$ 27,196	$ 27,196	$ 910	$ 910	$ 0	$ 0	$ 48,717	$ 48,717	$ 19,267	$ 19,267	$ 17,528	$ 17,528	$ 11,922	$ 11,922
Less: accumulated amortization																	(17,510)	(17,364)	(1,602)	(1,553)	(15,753)	(15,720)	(155)	(91)	(21,088)	(20,478)	(20,584)	(19,997)	(504)	(481)	0	0	(16,776)	(15,982)	(12,269)	(11,992)	(3,969)	(3,763)	(538)	(227)
Finite Lived Intangible Assets, Accumulated Impairment																									(27)	(27)	(27)	(27)	0	0	0	0	(19,543)	(19,543)	(6,421)	(6,421)	(13,122)	(13,122)	0	0
Finite-Lived Intangible Assets, Net	21,248	22,798	7,717	8,630	1,273	1,535	12,258	12,633									1,859	2,005	555	604	430	463	874	938	6,991	7,601	6,585	7,172	406	429	0	0	12,398	13,192	577	854	437	643	11,384	11,695
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	384,955	245,545	245,545	113,399	113,399	26,011	26,011
Indefinite Lived Intangible Assets, Accumulated Impairment									(151,471)	(151,471)	(144,672)	(144,672)	(6,799)	(6,799)	0	0
Indefinite Lived Intangible Assets, Net									233,484	233,484	100,873	100,873	106,600	106,600	26,011	26,011
Total identifiable intangible assets	$ 254,732	$ 256,282	$ 108,590	$ 109,503	$ 107,873	$ 108,135	$ 38,269	$ 38,644