Summary of Activity Related to Goodwill (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Goodwill and Intangible Assets [Line Items]
Beginning balance	$ 209,594,000	$ 334,700,000	$ 791,400,000
Additions	1,000,000	32,800,000	114,100,000
Goodwill, Impairment Loss	(1,300,000)	157,900,000	570,800,000
Goodwill, Written off Related to Sale of Business Unit	(400,000)
Ending balance	208,915,000	209,594,000	334,700,000
Home Health [Member]
Goodwill and Intangible Assets [Line Items]
Beginning balance	18,200,000	152,500,000	723,300,000
Additions	100,000	23,600,000	0
Goodwill, Impairment Loss	(1,300,000)	(157,900,000)	(570,800,000)
Goodwill, Written off Related to Sale of Business Unit	(400,000)
Ending balance	16,600,000	18,200,000	152,500,000
Hospice [Member]
Goodwill and Intangible Assets [Line Items]
Beginning balance	191,400,000	182,200,000	68,100,000
Additions	900,000	9,200,000	114,100,000
Goodwill, Impairment Loss	0	0	0
Goodwill, Written off Related to Sale of Business Unit	0
Ending balance	$ 192,300,000	$ 191,400,000	$ 182,200,000