Net Revenues and Accounts Receivable (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Net revenues by major payer classification
Net revenues	$ 498,006	$ 410,492	$ 1,483,551	$ 1,240,507
Percentage variance	21.30%		19.60%
Home Health [Member]
Net revenues by major payer classification
Net revenues	268,400	234,900	793,500	706,100
Hospice [Member]
Net revenues by major payer classification
Net revenues	172,400	175,600	519,100	534,400
Medicare [Member]
Net revenues by major payer classification
Net revenues	376,500	355,600	1,128,300	1,076,500
Percentage variance	5.90%		4.80%
Medicare [Member] | Home Health [Member]
Net revenues by major payer classification
Net revenues	214,900	191,800	642,000	577,700
Percentage variance	12.00%		11.10%
Medicare [Member] | Hospice [Member]
Net revenues by major payer classification
Net revenues	161,600	163,800	486,300	498,800
Percentage variance	(1.30%)		(2.50%)
Medicaid and Local Government [Member]
Net revenues by major payer classification
Net revenues	70,900	17,400	212,800	54,400
Percentage variance	307.00%		291.40%
Medicaid and Local Government [Member] | Home Health [Member]
Net revenues by major payer classification
Net revenues	8,600	10,800	25,700	33,100
Medicaid and Local Government [Member] | Hospice [Member]
Net revenues by major payer classification
Net revenues	6,100	6,600	18,600	21,300
Commercial Insurance and Other [Member]
Net revenues by major payer classification
Net revenues	50,600	37,500	142,500	109,700
Percentage variance	35.00%		29.90%
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Net revenues by major payer classification
Net revenues	21,500	15,100	55,000	43,300
Percentage variance	42.80%		27.00%
Commercial Insurance and Other [Member] | Commercial Insurance Other [Member]
Net revenues by major payer classification
Net revenues	29,100	22,400	87,500	66,300
Percentage variance	29.70%		31.80%
Commercial Insurance and Other [Member] | Home Health [Member] | Paid at Episodic Rates [Member]
Net revenues by major payer classification
Net revenues	21,500	15,100	55,000	43,300
Commercial Insurance and Other [Member] | Home Health [Member] | Commercial Insurance Other [Member]
Net revenues by major payer classification
Net revenues	23,400	17,200	70,800	52,000
Commercial Insurance and Other [Member] | Hospice [Member] | Paid at Episodic Rates [Member]
Net revenues by major payer classification
Net revenues	0	0	0	0
Commercial Insurance and Other [Member] | Hospice [Member] | Commercial Insurance Other [Member]
Net revenues by major payer classification
Net revenues	$ 4,700	$ 5,200	$ 14,200	$ 14,300