Net Revenues and Accounts Receivable (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2011	Sep. 30, 2011	Jun. 30, 2011	Mar. 31, 2011	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Net revenues by major payer classification
Net revenues	$ 425,017	$ 424,444	$ 427,691	$ 435,652	$ 449,209	$ 449,748	$ 448,712	$ 451,109	$ 1,712,804	$ 1,798,778	$ 1,414,459
Home Health [Member]
Net revenues by major payer classification
Net revenues									948,019	1,012,566	1,062,945
Hospice [Member]
Net revenues by major payer classification
Net revenues									764,785	786,212	351,514
Medicare [Member]
Net revenues by major payer classification
Net revenues									1,464,556	1,528,272	1,148,856
Medicare [Member] | Home Health [Member]
Net revenues by major payer classification
Net revenues									749,042	799,240	822,690
Medicare [Member] | Hospice [Member]
Net revenues by major payer classification
Net revenues									715,514	729,032	326,166
Medicaid and Local Government [Member]
Net revenues by major payer classification
Net revenues									74,424	83,103	73,973
Medicaid and Local Government [Member] | Home Health [Member]
Net revenues by major payer classification
Net revenues									46,745	52,270	59,751
Medicaid and Local Government [Member] | Hospice [Member]
Net revenues by major payer classification
Net revenues									27,679	30,833	14,222
Commercial Insurance and Other [Member]
Net revenues by major payer classification
Net revenues									173,824	187,403	191,630
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Net revenues by major payer classification
Net revenues									85,200	77,638	86,457
Commercial Insurance and Other [Member] | Commercial Insurance Other [Member]
Net revenues by major payer classification
Net revenues									88,624	109,765	105,173
Commercial Insurance and Other [Member] | Home Health [Member] | Paid at Episodic Rates [Member]
Net revenues by major payer classification
Net revenues									85,200	77,638	86,457
Commercial Insurance and Other [Member] | Home Health [Member] | Commercial Insurance Other [Member]
Net revenues by major payer classification
Net revenues									67,032	83,418	94,047
Commercial Insurance and Other [Member] | Hospice [Member] | Paid at Episodic Rates [Member]
Net revenues by major payer classification
Net revenues									0	0	0
Commercial Insurance and Other [Member] | Hospice [Member] | Commercial Insurance Other [Member]
Net revenues by major payer classification
Net revenues									$ 21,592	$ 26,347	$ 11,126