Insurance Matters (Details) (USD $)	6 Months Ended								6 Months Ended
	Jun. 30, 2013 Center Lawsuit	Jun. 30, 2012	Dec. 31, 2012	Jun. 30, 2013 Scheduled for trial or arbitration over next 12 months Lawsuit	Jun. 30, 2013 Professional liability insurance policies 1 West Virginia Center	Jun. 30, 2013 Professional liability insurance policies 2 West Virginia Center	Jun. 30, 2013 Professional liability insurance policies 2 Kentucky Center	Jun. 30, 2013 Professional malpractice liability insurance	Jun. 30, 2013 Professional malpractice liability insurance Professional liability insurance policies 1	Jun. 30, 2013 Professional malpractice liability insurance Professional liability insurance policies 2	Jun. 30, 2013 Professional malpractice liability insurance Professional Liability Insurance Policies 3	Jun. 30, 2013 Prefunded deductible policy	Jun. 01, 2010 Minimum Insurance_Policy	Jun. 01, 2010 Maximum Insurance_Policy
Malpractice Insurance [Line Items]
Number of types of professional liability insurance policies													1	4
Number of nursing centers	53				2	1	2
Insurance policy coverage limits per claim									$ 500,000	$ 1,000,000	$ 1,000,000	$ 500,000
Maximum claim amount on insurance									1,000,000	15,000,000	15,000,000
Professional liability insurance, deductible										495,000
Workers compensation insurance, maximum annual aggregate self-insured amount										3,000,000	3,000,000
Liability for reported and estimated future claims								26,805,000
Number of professional liability lawsuits	51			9
Cash expenditures for self-insured professional liability costs	3,290,000	2,988,000
Non-current receivables for workers' compensation policy	850,000		1,238,000
Other Insurance Industry Disclosures [Abstract]
Professional liability insurance, annual coverage limit per facility												3,000,000
Liability for workers compensation claims	266,000
Workers compensation insurance, non current receivable for excess premiums paid	1,077,000
Health insurance, maximum self-insured annual amount per individual	175,000
Liability for reported claims and estimates for incurred but unreported claims	$ 747,000