Schedule of Segment Reporting Information (Detail) (USD $)	3 Months Ended																12 Months Ended
	Dec. 31, 2012		Sep. 30, 2012		Jun. 30, 2012		Mar. 31, 2012		Dec. 31, 2011		Sep. 30, 2011		Jun. 30, 2011		Mar. 31, 2011		Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Segment Reporting Information [Line Items]
Net service revenue	$ 363,000,000	[1],[2],[3],[4]	$ 375,600,000	[1]	$ 378,500,000	[1]	$ 370,800,000	[1]	$ 370,300,000	[5],[6],[7]	$ 370,300,000	[6],[7],[8]	$ 368,400,000	[6],[9]	$ 359,300,000	[5],[6]	$ 1,487,905,000	$ 1,468,305,000	$ 1,601,070,000
Cost of service, excluding depreciation and amortization																	841,146,000	780,606,000	793,991,000
General and administrative expenses																	535,259,000	525,647,000	543,296,000
Provision for doubtful accounts																	21,676,000	13,514,000	18,740,000
Depreciation and amortization																	39,926,000	38,558,000	33,762,000
Goodwill and other intangibles impairment charge	110,200,000								3,800,000		434,600,000						162,103,000	579,955,000
Operating expenses																	1,600,110,000	1,938,280,000	1,389,789,000
Operating (loss) income																	(112,205,000)	(469,975,000)	211,281,000
Home Health
Segment Reporting Information [Line Items]
Net service revenue																	1,198,000,000	1,250,500,000	1,462,500,000
Cost of service, excluding depreciation and amortization																	691,100,000	664,000,000	719,900,000
General and administrative expenses																	350,800,000	340,200,000	376,400,000
Provision for doubtful accounts																	17,800,000	12,300,000	17,700,000
Depreciation and amortization																	13,900,000	14,000,000	14,300,000
Goodwill and other intangibles impairment charge																	161,600,000	579,900,000
Operating expenses																	1,235,200,000	1,610,400,000	1,128,300,000
Operating (loss) income																	(37,200,000)	(359,900,000)	334,200,000
Hospice care center
Segment Reporting Information [Line Items]
Net service revenue																	289,900,000	217,800,000	138,600,000
Cost of service, excluding depreciation and amortization																	150,000,000	116,600,000	74,100,000
General and administrative expenses																	72,400,000	50,000,000	34,300,000
Provision for doubtful accounts																	3,900,000	1,200,000	1,000,000
Depreciation and amortization																	1,500,000	700,000	500,000
Goodwill and other intangibles impairment charge																	500,000
Operating expenses																	228,300,000	168,500,000	109,900,000
Operating (loss) income																	61,600,000	49,300,000	28,700,000
Other
Segment Reporting Information [Line Items]
General and administrative expenses																	112,100,000	135,500,000	132,600,000
Depreciation and amortization																	24,500,000	23,900,000	19,000,000
Operating expenses																	136,600,000	159,400,000	151,600,000
Operating (loss) income																	$ (136,600,000)	$ (159,400,000)	$ (151,600,000)

[1] During each of the four quarters of 2012, we incurred certain costs associated with the U.S. Department of Justice Civil Investigative Demand. Net of income taxes, these costs amounted to $2.2 million, $0.8 million, $0.6 million and $1.4 million for the three-month periods ended March 31, 2012, June 30, 2012, September 30, 2012 and December 31, 2012, respectively.

[2] Our results for the three month period ended December 31, 2012, included the settlement of a lawsuit in the amount of $2.1 million, net of income taxes

[3] During the fourth quarter of 2012, we incurred costs associated with the prepayment of the term loan and a portion of our existing senior notes associated with our March 26, 2008 Senior Credit Facility. Net of income taxes, these costs amounted to $2.8 million.

[4] During the fourth quarter of 2012, we recognized a non-cash goodwill and other intangibles impairment charge of $110.2 million, net of income taxes and non-controlling interests.

[5] During the first and fourth quarters of 2011, we incurred costs associated with our exit activities. See Note 13 to the consolidated financial statements for further details. Net of income taxes, these costs amounted to $0.7 million and $3.1 million for the three-month periods ended March 31, 2011 and December 31, 2011, respectively.

[6] During each of the four quarters of 2011, we incurred certain costs associated with the realignment of our operations and legal expenses related to the United States Senate Committee on Finance inquiry and SEC investigation. Net of income taxes, these costs amounted to $2.0 million, $0.7 million, $1.6 million and $1.8 million for the three-month periods ended March 31, 2011, June 30, 2011, September 30, 2011 and December 31, 2011, respectively.

[7] During the third quarter of 2011, we recognized an estimated non-cash goodwill and other intangibles impairment charge of $434.6 million, net of income taxes. During the fourth quarter of 2011, we finalized our interim test of impairment of goodwill and as a result, recognized an additional non-cash goodwill and other intangibles impairment charge in the amount of $3.8 million, net of income taxes.

[8] Our results for the three month period ended September 30, 2011, included a release of a valuation allowance related to specific deferred tax assets in the amount of $1.9 million, net of income taxes.

[9] Our results for the three month period ended June 30, 2011, included a CMS bonus payment of $2.9 million net of income taxes as the result of the pay for performance demonstration.