Summary of Activity Related to Goodwill (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Goodwill and Other Assets Disclosure [Line Items]
Beginning Balance	$ 334,695	$ 791,400	$ 786,900
Additions	32,800	114,100	4,500
Impairment	(157,900)	(570,800)
Ending Balance	209,594	334,695	791,400
Home Health
Goodwill and Other Assets Disclosure [Line Items]
Beginning Balance	152,500	723,300	719,900
Additions	23,600		3,400
Impairment	(157,900)	(570,800)
Ending Balance	18,200	152,500	723,300
Hospice care center
Goodwill and Other Assets Disclosure [Line Items]
Beginning Balance	182,200	68,100	67,000
Additions	9,200	114,100	1,100
Ending Balance	$ 191,400	$ 182,200	$ 68,100