Identifiable Intangible Assets and Goodwill (Details) (USD $) In Thousands, unless otherwise specified																															12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2012 Home Health [Member]	Dec. 31, 2011 Home Health [Member]	Dec. 31, 2012 Hospice [Member]	Dec. 31, 2011 Hospice [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member]	Dec. 31, 2011 Medicare licenses and certificates of need [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member] Home Health [Member]	Dec. 31, 2011 Medicare licenses and certificates of need [Member] Home Health [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member] Hospice [Member]	Dec. 31, 2011 Medicare licenses and certificates of need [Member] Hospice [Member]	Dec. 31, 2012 Covenants not to compete [Member]	Dec. 31, 2011 Covenants not to compete [Member]	Dec. 31, 2012 Covenants not to compete [Member] Home Health [Member]	Dec. 31, 2011 Covenants not to compete [Member] Home Health [Member]	Dec. 31, 2012 Covenants not to compete [Member] Hospice [Member]	Dec. 31, 2011 Covenants not to compete [Member] Hospice [Member]	Dec. 31, 2012 Customer Relationships [Member]	Dec. 31, 2011 Customer Relationships [Member]	Dec. 31, 2012 Customer Relationships [Member] Home Health [Member]	Dec. 31, 2011 Customer Relationships [Member] Home Health [Member]	Dec. 31, 2012 Customer Relationships [Member] Hospice [Member]	Dec. 31, 2011 Customer Relationships [Member] Hospice [Member]	Dec. 31, 2012 Trade Names [Member]	Dec. 31, 2011 Trade Names [Member]	Dec. 31, 2012 Trade Names [Member] Home Health [Member]	Dec. 31, 2011 Trade Names [Member] Home Health [Member]	Dec. 31, 2012 Trade Names [Member] Hospice [Member]	Dec. 31, 2011 Trade Names [Member] Hospice [Member]	Dec. 31, 2012 Maximum [Member] Covenants not to compete [Member]	Dec. 31, 2012 Maximum [Member] Customer Relationships [Member]	Dec. 31, 2012 Maximum [Member] Trade Names [Member]	Dec. 31, 2012 Minimum [Member] Covenants not to compete [Member]	Dec. 31, 2012 Minimum [Member] Customer Relationships [Member]	Dec. 31, 2012 Minimum [Member] Trade Names [Member]
Amortized intangible assets:
Finite-Lived Intangible Assets, Gross													$ 17,352	$ 17,148	$ 1,667	$ 1,473	$ 15,685	$ 15,675	$ 28,106	$ 28,106	$ 27,196	$ 27,196	$ 910	$ 910	$ 34,945	$ 34,945	$ 18,215	$ 18,215	$ 16,730	$ 16,730
Less: accumulated amortization													(15,562)	(10,555)	(1,449)	(1,411)	(14,113)	(9,144)	(18,041)	(15,603)	(17,651)	(15,304)	(390)	(299)	(15,402)	(12,868)	(11,794)	(10,522)	(3,608)	(2,346)
Finite Lived Intangible Assets, Accumulated Impairment																			(27)	(27)	(27)	(27)	0	0	(19,543)	(411)	(6,421)	(411)	(13,122)	0
Finite-Lived Intangible Assets, Net	11,828	40,735	9,736	19,209	2,092	21,526							1,790	6,593	218	62	1,572	6,531	10,038	12,476	9,518	11,865	520	611	0	21,666	0	7,282	0	14,384
Finite-Lived Intangible Asset, useful life																															5 years	10 years	10 years	2 years	5 years	5 years
Indefinite-lived intangible assets:
Indefinite-Lived Intangible Assets							326,976	318,811	225,227	220,285	101,749	98,526
Indefinite Lived Intangible Assets, Accumulated Impairment							(145,191)	(144,672)	(144,672)	(144,672)	(519)	0
Indefinite Lived Intangible Assets, Net							181,785	174,139	80,555	75,613	101,230	98,526
Total identifiable intangible assets	$ 193,613	$ 214,874	$ 90,291	$ 94,822	$ 103,322	$ 120,052