Fair Value of Financial Instruments (Details 1) (USD $) In Thousands, unless otherwise specified	Sep. 30, 2013	Dec. 31, 2012
Carrying Amount [Member]
Assets:
Note receivable from CareCentrix	$ 25,000	$ 25,000
Seller financing note receivable from CareCentrix	3,471	3,471
Liabilities:
Long-term obligation	910,182	935,182
Estimate Fair Value [Member]
Assets:
Note receivable from CareCentrix	26,483	25,220
Seller financing note receivable from CareCentrix	3,471	3,471
Liabilities:
Long-term obligation	$ 922,289	$ 912,818