Acquisitions Acquisition Summary (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014 Businesses	Mar. 31, 2013
Skilled nursing facility
Business Acquisition [Line Items]
Number of Businesses Acquired	1
Transitional Care Management company [Member]
Business Acquisition [Line Items]
Number of Businesses Acquired	1
Operations acquired in business combinations
Business Acquisition [Line Items]
Number of Businesses Acquired	2
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net	$ 9,148	$ 10,646