Identifiable Intangible Assets and Goodwill (Tables)

12 Months Ended

Dec. 31, 2012

Goodwill and Intangible Assets Disclosure [Abstract]

Gross carrying amount and accumulated amortization of identifiable intangible assets

The gross carrying amount and accumulated amortization of each category of identifiable intangible assets as of December 31, 2012 and December 31, 2011 were as follows (in thousands):

	December 31, 2012									December 31, 2011									Useful Life
	Home Health			Hospice			Total			Home Health			Hospice			Total
Amortized intangible assets:
Covenants not to compete	$	1,667		$	15,685		$	17,352		$	1,473		$	15,675		$	17,148		2-5 Yrs
Less: accumulated amortization	(1,449		)	(14,113		)	(15,562		)	(1,411		)	(9,144		)	(10,555		)
Net covenants not to compete	218			1,572			1,790			62			6,531			6,593
Customer relationships	27,196			910			28,106			27,196			910			28,106			5-10 Yrs
Less: accumulated amortization	(17,651		)	(390		)	(18,041		)	(15,304		)	(299		)	(15,603		)
accumulated impairment losses	(27		)	—			(27		)	(27		)	—			(27		)
Net customer relationships	9,518			520			10,038			11,865			611			12,476
Tradenames	18,215			16,730			34,945			18,215			16,730			34,945			5-10 Yrs
Less: accumulated amortization	(11,794		)	(3,608		)	(15,402		)	(10,522		)	(2,346		)	(12,868		)
accumulated impairment losses	(6,421		)	(13,122		)	(19,543		)	(411		)	—			(411		)
Net tradenames	—			—			—			7,282			14,384			21,666
Amortized intangible assets	9,736			2,092			11,828			19,209			21,526			40,735
Indefinite-lived intangible assets:
Medicare licenses and certificates of need	225,227			101,749			326,976			220,285			98,526			318,811
Less: accumulated impairment losses	(144,672		)	(519		)	(145,191		)	(144,672		)	—			(144,672		)
Net Medicare licenses and certificates of need	80,555			101,230			181,785			75,613			98,526			174,139
Total identifiable intangible assets	$	90,291		$	103,322		$	193,613		$	94,822		$	120,052		$	214,874

Gross carrying amount of goodwill

The gross carrying amount of goodwill as of December 31, 2012 and December 31, 2011 and activity during the years 2012 and 2011 were as follows (in thousands):

	Home Health			Hospice			Total
Balance at December 31, 2010	$	264,679		$	820,387		$	1,085,066
Goodwill adjustment	2,379			11,261			13,641
Accumulated impairment losses	(263,370		)	(193,667		)	(457,037		)
Balance at December 31, 2011	3,688			637,981			641,669
Goodwill acquired during 2012	5,331			9,364			14,695
Balance at December 31, 2012	$	9,019		$	647,345		$	656,364