Variable Interest Entity (Details Textual)	9 Months Ended
	Sep. 30, 2013	Dec. 27, 2011 Bed
Variable Interest Entity, Not Primary Beneficiary [Abstract]
Number of licensed nursing beds	4,882
Lease agreement with the real estate developing period	20 years
Maximum number of capital lease renewal periods	2
Equity interest in entity	0.00%
Minimum
Variable Interest Entity, Not Primary Beneficiary [Abstract]
Agreement provides company right to purchase	110.00%
Maximum
Variable Interest Entity, Not Primary Beneficiary [Abstract]
Agreement provides company right to purchase	120.00%
Variable Interest Entity, Not Primary Beneficiary | Culloden, WV
Variable Interest Entity, Not Primary Beneficiary [Abstract]
Number of licensed nursing beds		90
Capital lease renewal period	5 years