Summary of Activity Related to Other Intangible Assets, Net (Detail) (USD $)	3 Months Ended	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Goodwill and Intangible Assets [Line Items]
Beginning balance		$ 47,050,000	$ 50,000,000	$ 53,400,000
Additions		600,000	4,000,000	10,300,000
Write-off		(1,100,000)		(1,100,000)
Amortization		(1,600,000)	(2,800,000)	(3,500,000)
Other intangibles impairment charge	4,600,000	(8,200,000)	(4,200,000)	(9,100,000)
Ending balance	36,690,000	36,690,000	47,050,000	50,000,000
NonCompete Agreements Reacquired Franchise Rights [Member]
Goodwill and Intangible Assets [Line Items]
Beginning balance		1,800,000	4,200,000	7,000,000
Additions		0	400,000	500,000
Write-off		0		0
Amortization		(1,600,000)	(2,800,000)	(3,300,000)
Other intangibles impairment charge		0	0	0
Ending balance	200,000	200,000	1,800,000	4,200,000
Certificates Of Need And Licenses [Member]
Goodwill and Intangible Assets [Line Items]
Beginning balance		33,700,000	34,000,000	41,700,000
Additions		600,000	3,600,000	2,500,000
Write-off		(1,100,000)		(1,100,000)
Amortization		0	0	0
Other intangibles impairment charge		(7,800,000)	(3,900,000)	(9,100,000)
Ending balance	25,400,000	25,400,000	33,700,000	34,000,000
Acquired Names Of Business [Member]
Goodwill and Intangible Assets [Line Items]
Beginning balance		11,500,000	11,800,000	4,700,000
Additions		0	0	7,300,000
Write-off		0		0
Amortization		0	0	(200,000)
Other intangibles impairment charge		(400,000)	(300,000)	0
Ending balance	$ 11,100,000	$ 11,100,000	$ 11,500,000	$ 11,800,000