Cost Savings Initiatives and Other Restructuring Costs, Acquisition and Integration Activities and Legal Settlements (Details Textual) (USD $)	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	Jan. 03, 2010
Segment Reporting Information [Line Items]
Charge	$ 201,000	$ 53,000	$ 25,000	$ 5,391,000	$ 14,282,000	$ 9,845,000	$ 21,246,000	$ 3,765,000	$ 5,670,000	$ 49,138,000	$ 46,003,000
Restructuring reserve	2,696,000				38,379,000				2,696,000	38,379,000	19,377,000	3,646,000
Non-cash compensation expense										400,000	600,000
Cost Savings Initiative [Member]
Segment Reporting Information [Line Items]
Charge									1,701,000	15,259,000	6,269,000
Restructuring reserve	1,685,000				8,671,000				1,685,000	8,671,000	2,893,000	646,000
Branch Closures [Member]
Segment Reporting Information [Line Items]
Charge									1,700,000	13,200,000
Acquisition Integration [Member]
Segment Reporting Information [Line Items]
Charge									(989,000)	7,879,000	26,040,000
Restructuring reserve	1,011,000				3,708,000				1,011,000	3,708,000	3,984,000	0
Legal Settlements [Member]
Segment Reporting Information [Line Items]
Charge									4,958,000	26,000,000	13,694,000
Restructuring reserve	0				26,000,000				0	26,000,000	12,500,000	3,000,000
Legal Settlements CareCentrix [Member]
Segment Reporting Information [Line Items]
Charge											4,200,000
Legal Settlements Government [Member]
Segment Reporting Information [Line Items]
Charge											$ 9,500,000
Home Health [Member]
Segment Reporting Information [Line Items]
Number of branches divested									46
Hospice [Member]
Segment Reporting Information [Line Items]
Number of branches divested									13