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Revenue and Accounts Receivable Revenue YTD (Details) (USD $)
In Thousands, unless otherwise specified
12 Months Ended
Dec. 31, 2012
Rate
Dec. 31, 2011
Rate
Dec. 31, 2010
Rate
Health Care Organization, Receivable and Revenue Disclosures [Line Items]      
Revenue $ 824,719 $ 758,277 $ 649,532
% of Revenue 100.00% 100.00% 100.00%
Medicaid
     
Health Care Organization, Receivable and Revenue Disclosures [Line Items]      
Revenue 302,046 277,736 259,711
% of Revenue 36.60% 36.60% 40.00%
Medicare
     
Health Care Organization, Receivable and Revenue Disclosures [Line Items]      
Revenue 278,578 272,283 219,217
% of Revenue 33.80% 35.90% 33.70%
Medicaid — skilled
     
Health Care Organization, Receivable and Revenue Disclosures [Line Items]      
Revenue 25,418 20,290 17,573
% of Revenue 3.10% 2.70% 2.70%
Total Medicaid and Medicare
     
Health Care Organization, Receivable and Revenue Disclosures [Line Items]      
Revenue 606,042 570,309 496,501
% of Revenue 73.50% 75.20% 76.40%
Managed care
     
Health Care Organization, Receivable and Revenue Disclosures [Line Items]      
Revenue 106,268 94,266 84,364
% of Revenue 12.90% 12.40% 13.00%
Private and other payors
     
Health Care Organization, Receivable and Revenue Disclosures [Line Items]      
Revenue $ 112,409 $ 93,702 $ 68,667
% of Revenue 13.60% 12.40% 10.60%