Exit Activities (Detail) (USD $)	9 Months Ended	12 Months Ended
	Sep. 30, 2013 Agencies	Dec. 31, 2013 Agencies	Dec. 31, 2012 Agencies	Dec. 31, 2011 Agencies
Restructuring Cost and Reserve [Line Items]
Gains (Losses) on Sales of Assets		$ 1,752,000	$ 0	$ 0
Proceeds from Divestiture of Business		5,146,000	0	0
Number of care centers available for sale	28	3
Number of care centers consolidated		46
Number of care centers sold		20
Number of care centers closed		10	3	29
Home Health [Member]
Restructuring Cost and Reserve [Line Items]
Number of care centers available for sale		3
Number of care centers consolidated		41	5	27
Number of care centers sold		19
Number of care centers closed		10	3	27
Number of care centers start-up process discontinued				2
Hospice [Member]
Restructuring Cost and Reserve [Line Items]
Number of care centers available for sale		0
Number of care centers consolidated		5	4	5
Number of care centers sold		1
Number of care centers closed				2
Alaska and Washington Care Centers [Member]
Restructuring Cost and Reserve [Line Items]
Gains (Losses) on Sales of Assets		1,000,000
Proceeds from Divestiture of Business		1,600,000
Alaska and Washington Care Centers [Member] | Home Health [Member]
Restructuring Cost and Reserve [Line Items]
Number of care centers sold		2
Alaska and Washington Care Centers [Member] | Hospice [Member]
Restructuring Cost and Reserve [Line Items]
Number of care centers sold		1
Unconsolidated Joint Venture [Member]
Restructuring Cost and Reserve [Line Items]
Gains (Losses) on Sales of Assets		(700,000)
Proceeds from Divestiture of Business		500,000
Georgia Care Centers [Member]
Restructuring Cost and Reserve [Line Items]
Gains (Losses) on Sales of Assets		1,400,000
Proceeds from Divestiture of Business		1,600,000
Available For Sale [Member]
Restructuring Cost and Reserve [Line Items]
Gains (Losses) on Sales of Assets		700,000
Proceeds from Divestiture of Business		1,400,000
Number of care centers sold		17
Number of care centers closed		8
Not Included In Available For Sale [Member]
Restructuring Cost and Reserve [Line Items]
Number of care centers closed		2
2011 Exit Activity [Member]
Restructuring Cost and Reserve [Line Items]
Discontinued Operations Liability				2,700,000
2011 Exit Activity [Member] | Lease Termination [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs				3,100,000
2011 Exit Activity [Member] | Severance [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs				700,000
2011 Exit Activity [Member] | Intangibles Write Off [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs				1,500,000
2012 Exit Activity [Member]
Restructuring Cost and Reserve [Line Items]
Discontinued Operations Liability			200,000
2012 Exit Activity [Member] | Lease Termination [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs			900,000
2012 Exit Activity [Member] | Severance [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs			100,000
2013 Exit Activity [Member] | Lease Termination [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs		1,500,000
2013 Exit Activity [Member] | Severance [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs		1,800,000
2013 Exit Activity [Member] | Goodwill And Other Intangibles Impairment [Member]
Restructuring Cost and Reserve [Line Items]
Other Restructuring Costs		3,500,000
2013 Exit Activity [Member] | Available For Sale [Member] | Lease Termination [Member]
Restructuring Cost and Reserve [Line Items]
Discontinued Operations Liability		500,000
2013 Exit Activity [Member] | Available For Sale [Member] | Intangibles Write Off [Member]
Restructuring Cost and Reserve [Line Items]
Discontinued Operations Liability		$ 100,000