Business Segment Information (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
Segment net revenues by major payer source
Total 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
Medicare [Member]
Segment net revenues by major payer source
Total net revenues									1,464,556	1,528,272	1,148,856
Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues									74,424	83,103	73,973
Commercial Insurance and Other [Member]
Segment net revenues by major payer source
Total net revenues									173,824	187,403	191,630
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues									85,200	77,638	86,457
Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues									88,624	109,765	105,173
Home Health [Member]
Segment net revenues by major payer source
Total net revenues									948,019	1,012,566	1,062,945
Home Health [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues									749,042	799,240	822,690
Home Health [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues									46,745	52,270	59,751
Home Health [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues									85,200	77,638	86,457
Home Health [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues									67,032	83,418	94,047
Hospice [Member]
Segment net revenues by major payer source
Total net revenues									764,785	786,212	351,514
Hospice [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues									715,514	729,032	326,166
Hospice [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues									27,679	30,833	14,222
Hospice [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues									0	0	0
Hospice [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues									$ 21,592	$ 26,347	$ 11,126