Nature of Operations Consolidation and Presentation of Financial Statements - Additional Information (Detail) (USD $)	9 Months Ended	12 Months Ended
	Sep. 30, 2013 Agencies	Dec. 31, 2013 Agencies States	Dec. 31, 2012 Agencies	Dec. 31, 2011 Agencies
Organization And Nature Of Operations [Line Items]
Percent Of Net Services Revenue Provided By Medicare		84.00%	82.00%	85.00%
Number Of States With Facilities		37
Number of care centers closed		10	3	29
Minimum percent ownership for controlling interest percent		50.00%
Equity Method Investment Aggregate Cost		$ 11,900,000	$ 8,900,000
Cost Method Investments		5,000,000
Maximum Percent Ownership For Equity Method Percent		50.00%
Maximum Percent Ownership For Cost Method Percent		20.00%
Number of care centers consolidated		46
Number of care centers available for sale	28	3
Number of care centers sold		20
Gains (Losses) on Sales of Assets		1,752,000	0	0
Goodwill, Impairment Loss		(1,300,000)	157,900,000	570,800,000
Proceeds from Divestiture of Business		5,146,000	0	0
Georgia Care Centers [Member]
Organization And Nature Of Operations [Line Items]
Gains (Losses) on Sales of Assets		1,400,000
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners		30.00%
Number of care centers contributed to joint venture		3
Proceeds from Divestiture of Business		1,600,000
Home Health [Member]
Organization And Nature Of Operations [Line Items]
Operating Care Centers		367
Number of care centers closed		10	3	27
Number of care centers consolidated		41	5	27
Number of care centers available for sale		3
Number of care centers sold		19
Goodwill, Impairment Loss		(1,300,000)	(157,900,000)	(570,800,000)
Hospice [Member]
Organization And Nature Of Operations [Line Items]
Operating Care Centers		92
Number of care centers closed				2
Number of care centers consolidated		5	4	5
Number of care centers available for sale		0
Number of care centers sold		1
Goodwill, Impairment Loss		$ 0	$ 0	$ 0
Hospice Inpatient [Member]
Organization And Nature Of Operations [Line Items]
Operating Care Centers		1