Operating Income of Reportable Segments (Detail) (USD $)	3 Months Ended		6 Months Ended
	Jun. 30, 2013	Jun. 30, 2012	Jun. 30, 2013	Jun. 30, 2012
Segment Reporting Information [Line Items]
Net service revenue	$ 313,148,000	$ 363,068,000	$ 639,201,000	$ 719,056,000
Cost of service, excluding depreciation and amortization	176,077,000	202,586,000	360,233,000	401,637,000
General and administrative expenses	116,900,000	130,900,000	240,100,000	259,300,000
Provision for doubtful accounts	4,658,000	4,534,000	8,502,000	10,217,000
Depreciation and amortization	11,674,000	9,678,000	21,621,000	19,515,000
Operating expenses	309,355,000	347,711,000	630,418,000	690,659,000
Operating (loss) income	3,793,000	15,357,000	8,783,000	28,397,000
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenue	248,600,000	290,600,000	508,800,000	578,400,000
Cost of service, excluding depreciation and amortization	142,000,000	165,300,000	291,300,000	328,500,000
General and administrative expenses	75,600,000	81,500,000	155,100,000	165,600,000
Provision for doubtful accounts	3,000,000	3,900,000	5,000,000	8,800,000
Depreciation and amortization	2,600,000	3,400,000	5,300,000	6,600,000
Operating expenses	223,200,000	254,100,000	456,700,000	509,500,000
Operating (loss) income	25,400,000	36,500,000	52,100,000	68,900,000
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenue	64,500,000	72,500,000	130,400,000	140,600,000
Cost of service, excluding depreciation and amortization	34,100,000	37,300,000	68,900,000	73,100,000
General and administrative expenses	15,600,000	17,800,000	32,800,000	34,000,000
Provision for doubtful accounts	1,600,000	600,000	3,500,000	1,400,000
Depreciation and amortization	500,000	300,000	1,100,000	600,000
Operating expenses	51,800,000	56,000,000	106,300,000	109,100,000
Operating (loss) income	12,700,000	16,500,000	24,100,000	31,500,000
All Other Segments [Member]
Segment Reporting Information [Line Items]
Net service revenue	0	0	0	0
Cost of service, excluding depreciation and amortization	0	0	0	0
General and administrative expenses	25,700,000	31,600,000	52,200,000	59,700,000
Provision for doubtful accounts	0	0	0	0
Depreciation and amortization	8,600,000	6,000,000	15,200,000	12,300,000
Operating expenses	34,300,000	37,600,000	67,400,000	72,000,000
Operating (loss) income	$ (34,300,000)	$ (37,600,000)	$ (67,400,000)	$ (72,000,000)