Goodwill and Identifiable Intangible Assets (Details) (USD $) In Thousands, unless otherwise specified																																									9 Months Ended
	Sep. 30, 2014	Dec. 31, 2013	Sep. 30, 2014 Home Health [Member]	Dec. 31, 2013 Home Health [Member]	Sep. 30, 2014 Hospice [Member]	Dec. 31, 2013 Hospice [Member]	Sep. 30, 2014 Community Care [Member]	Dec. 31, 2013 Community Care [Member]	Sep. 30, 2014 Licenses and certificates of need [Member]	Dec. 31, 2013 Licenses and certificates of need [Member]	Sep. 30, 2014 Licenses and certificates of need [Member] Home Health [Member]	Dec. 31, 2013 Licenses and certificates of need [Member] Home Health [Member]	Sep. 30, 2014 Licenses and certificates of need [Member] Hospice [Member]	Dec. 31, 2013 Licenses and certificates of need [Member] Hospice [Member]	Sep. 30, 2014 Licenses and certificates of need [Member] Community Care [Member]	Dec. 31, 2013 Licenses and certificates of need [Member] Community Care [Member]	Sep. 30, 2014 Covenants not to compete [Member]	Dec. 31, 2013 Covenants not to compete [Member]	Sep. 30, 2014 Covenants not to compete [Member] Home Health [Member]	Dec. 31, 2013 Covenants not to compete [Member] Home Health [Member]	Sep. 30, 2014 Covenants not to compete [Member] Hospice [Member]	Dec. 31, 2013 Covenants not to compete [Member] Hospice [Member]	Sep. 30, 2014 Covenants not to compete [Member] Community Care [Member]	Dec. 31, 2013 Covenants not to compete [Member] Community Care [Member]	Sep. 30, 2014 Customer Relationships [Member]	Dec. 31, 2013 Customer Relationships [Member]	Sep. 30, 2014 Customer Relationships [Member] Home Health [Member]	Dec. 31, 2013 Customer Relationships [Member] Home Health [Member]	Sep. 30, 2014 Customer Relationships [Member] Hospice [Member]	Dec. 31, 2013 Customer Relationships [Member] Hospice [Member]	Sep. 30, 2014 Customer Relationships [Member] Community Care [Member]	Dec. 31, 2013 Customer Relationships [Member] Community Care [Member]	Sep. 30, 2014 Trade Names [Member]	Dec. 31, 2013 Trade Names [Member]	Sep. 30, 2014 Trade Names [Member] Home Health [Member]	Dec. 31, 2013 Trade Names [Member] Home Health [Member]	Sep. 30, 2014 Trade Names [Member] Hospice [Member]	Dec. 31, 2013 Trade Names [Member] Hospice [Member]	Sep. 30, 2014 Trade Names [Member] Community Care [Member]	Dec. 31, 2013 Trade Names [Member] Community Care [Member]	Sep. 30, 2014 Maximum [Member] Covenants not to compete [Member]	Sep. 30, 2014 Maximum [Member] Customer Relationships [Member]	Sep. 30, 2014 Maximum [Member] Trade Names [Member]	Sep. 30, 2014 Minimum [Member] Covenants not to compete [Member]	Sep. 30, 2014 Minimum [Member] Customer Relationships [Member]	Sep. 30, 2014 Minimum [Member] Trade Names [Member]
Amortized intangible assets:
Finite-Lived Intangible Assets, Gross									$ 10,003	$ 8,735	$ 714	$ 714	$ 9,289	$ 8,021	$ 0	$ 0	$ 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									(9,496)	(7,400)	(714)	(588)	(8,782)	(6,812)	0	0	(17,873)	(17,364)	(1,709)	(1,553)	(15,837)	(15,720)	(327)	(91)	(22,252)	(20,478)	(21,703)	(19,997)	(549)	(481)	0	0	(18,297)	(15,982)	(12,795)	(11,992)	(4,368)	(3,763)	(1,134)	(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	18,707	24,133	5,965	8,756	1,252	2,744	11,490	12,633	507	1,335	0	126	507	1,209	0	0	1,496	2,005	448	604	346	463	702	938	5,827	7,601	5,466	7,172	361	429	0	0	10,877	13,192	51	854	38	643	10,788	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									375,461	376,729	245,086	245,086	104,364	105,632	26,011	26,011
Indefinite Lived Intangible Assets, Accumulated Impairment									(147,135)	(147,135)	(144,672)	(144,672)	(2,463)	(2,463)	0	0
Indefinite Lived Intangible Assets, Net									228,326	229,594	100,414	100,414	101,901	103,169	26,011	26,011
Total identifiable intangible assets	$ 247,033	$ 253,727	$ 106,379	$ 109,170	$ 103,153	$ 105,913	$ 37,501	$ 38,644