Acquisitions Acquisition Summary (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
Dec. 31, 2014 Businesses	Dec. 31, 2013 Operations	Dec. 31, 2012 Operations
Business Acquisition [Line Items]
Number of Businesses Acquired	27us-gaap_NumberOfBusinessesAcquired	17us-gaap_NumberOfBusinessesAcquired	9us-gaap_NumberOfBusinessesAcquired
Aggregate Acquisition Price	$ 96,085	$ 45,364	$ 45,650
Cash payment to acquire businesses	$ 92,669	$ 45,101	$ 31,558
Assisted Living Facility [Member]
Business Acquisition [Line Items]
Number of Businesses Acquired	3	3	1
Skilled nursing facility
Business Acquisition [Line Items]
Number of Businesses Acquired	15	7	5
Transitional Care Management company [Member]
Business Acquisition [Line Items]
Number of Businesses Acquired	1
621610 Home Health Care Services [Member]
Business Acquisition [Line Items]
Number of Businesses Acquired	3	3	2
Hospice Agency [Member]
Business Acquisition [Line Items]
Number of Businesses Acquired	4	3	1
Primary Care Group [Member]
Business Acquisition [Line Items]
Number of Businesses Acquired	1

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The number of businesses acquired by the entity during the period.

+ References

No definition available.

+ Details

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- Definition

The cash outflow associated with the acquisition of business during the period. The cash portion only of the acquisition price.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Investing Activities

-URI http://asc.fasb.org/extlink&oid=6516133

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 230

-SubTopic 10

-Section 45

-Paragraph 13

-Subparagraph (b)

-URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3213-108585

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- Definition

The cash outflow associated with the acquisition of a business, net of the cash acquired from the purchase.

+ References

+ Details

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