Operating Income of Reportable Segments (Detail) (USD $)	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Segment Reporting Information [Line Items]
Net service revenue	$ 303,500,000	$ 301,300,000	$ 315,900,000	$ 328,600,000	$ 351,600,000	$ 363,900,000	$ 366,200,000	$ 359,100,000	$ 1,249,344,000	$ 1,440,836,000	$ 1,418,464,000
Cost of service, excluding depreciation and amortization									717,996,000	810,704,000	750,439,000
General and administrative expenses									474,000,000	516,700,000	506,800,000
Provision for doubtful accounts									15,882,000	21,011,000	12,646,000
Depreciation and amortization									36,871,000	39,200,000	37,808,000
U.S. Department of Justice settlement									150,000,000	0	0
Goodwill and other intangibles impairment charge									9,492,000	162,103,000	579,955,000
Operating expenses									1,404,315,000	1,549,691,000	1,887,654,000
Operating income (loss)									(154,971,000)	(108,855,000)	(469,190,000)
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenue									987,700,000	1,152,100,000	1,201,800,000
Cost of service, excluding depreciation and amortization									578,900,000	661,400,000	634,500,000
General and administrative expenses									304,800,000	331,600,000	321,700,000
Provision for doubtful accounts									10,200,000	17,100,000	11,500,000
Depreciation and amortization									10,300,000	13,200,000	13,200,000
U.S. Department of Justice settlement									0
Goodwill and other intangibles impairment charge									8,500,000	161,600,000	579,900,000
Operating expenses									912,700,000	1,184,900,000	1,560,800,000
Operating income (loss)									75,000,000	(32,800,000)	(359,000,000)
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenue									261,600,000	288,700,000	216,600,000
Cost of service, excluding depreciation and amortization									139,100,000	149,300,000	115,900,000
General and administrative expenses									64,700,000	71,800,000	49,600,000
Provision for doubtful accounts									5,700,000	3,900,000	1,200,000
Depreciation and amortization									2,100,000	1,500,000	700,000
U.S. Department of Justice settlement									0
Goodwill and other intangibles impairment charge									1,000,000	500,000	0
Operating expenses									212,600,000	227,000,000	167,400,000
Operating income (loss)									49,000,000	61,700,000	49,200,000
All Other Segments [Member]
Segment Reporting Information [Line Items]
Net service revenue									0	0	0
Cost of service, excluding depreciation and amortization									0	0	0
General and administrative expenses									104,500,000	113,300,000	135,500,000
Provision for doubtful accounts									0	0	0
Depreciation and amortization									24,500,000	24,500,000	23,900,000
U.S. Department of Justice settlement									150,000,000
Goodwill and other intangibles impairment charge									0	0	0
Operating expenses									279,000,000	137,800,000	159,400,000
Operating income (loss)									$ (279,000,000)	$ (137,800,000)	$ (159,400,000)