Commitments and Contingencies - Additional Information (Detail) (USD $)	3 Months Ended		6 Months Ended			54 Months Ended	1 Months Ended	3 Months Ended		6 Months Ended				22 Months Ended	3 Months Ended			6 Months Ended
	Jun. 30, 2012	Jun. 30, 2011	Jun. 30, 2012	Jun. 30, 2011	Jul. 31, 2009	May 31, 2012 Large physician group	Jul. 31, 2012 Pending Litigation Person	Jun. 30, 2012 Home Health	Jun. 30, 2011 Home Health	Jun. 30, 2012 Home Health	Jun. 30, 2011 Home Health	Mar. 09, 2011 Home Health	Jan. 02, 2008 Home Health	Nov. 10, 2009 Home Health Medicare Administrative Contractor (MAC) Unfavorable	Jun. 30, 2012 Maximus Federal Services Unfavorable	Jun. 30, 2012 Hospice care centers	Jun. 30, 2011 Hospice care centers	Jun. 30, 2012 Hospice care centers	Jun. 30, 2011 Hospice care centers	May 31, 2012 Hospice care centers	Jun. 06, 2011 Hospice care centers	Jul. 31, 2010 Hospice care centers	Jun. 30, 2012 Hospice care centers Unfavorable	Jun. 30, 2012 Hospice care centers Favorable	Mar. 13, 2012 Maximus Federal Services And Hospice Unfavorable	Mar. 13, 2012 Maximus Federal Services And Hospice Favorable	Feb. 15, 2012 Masspro and Hospice	Feb. 15, 2012 Masspro and Hospice Unfavorable
Commitments and Contingencies Disclosure [Line Items]
Net service revenue	$ 378,498,000	$ 368,424,000	$ 749,331,000	$ 727,738,000		$ 4,000,000		$ 304,800,000	$ 321,600,000	$ 606,200,000	$ 642,400,000					$ 73,700,000	$ 46,800,000	$ 143,100,000	$ 85,300,000
Number of former employees who filled a putative collective and class action complaint							3
Description of plaintiffs class certification request							Plaintiffs seek class certification of similar employees and seek attorneys' fees, back wages and liquidated damages going back three years under the FLSA and three years under the Pennsylvania statute.
Number of claims submitted by subsidiary					25							114	137								16	30	12	4	11	1	112	89
Recovery amount of the overpayment made to the subsidiary	6,300,000		6,300,000									5,600,000								6,100,000	5,500,000						6,600,000
Number of redetermination decisions														110	85
Health insurance retention limit			800,000
Workers' compensation insurance retention limit			400,000
Professional liability insurance retention limit			$ 300,000