Cost Savings Initiatives and Other Restructuring Costs, Acquisition and Integration Activities and Legal Settlements (Details Textual) (USD $)	3 Months Ended						9 Months Ended
	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Sep. 30, 2013	Sep. 30, 2012	Dec. 31, 2012	Dec. 31, 2011
Segment Reporting Information [Line Items]
Restructuring charges	$ 1,699,000	$ 744,000	$ 141,000	$ 53,000	$ 25,000	$ 5,391,000	$ 2,600,000	$ 5,469,000
Restructuring reserve	2,412,000	1,236,000	1,411,000	3,801,000	5,361,000	13,333,000	2,412,000	3,801,000	2,696,000	38,379,000
Cost Savings Initiative [Member]
Segment Reporting Information [Line Items]
Restructuring charges	77,000	138,000	47,000	98,000	542,000	842,000	300,000	1,500,000
Restructuring reserve	394,000	81,000	628,000	2,599,000	3,971,000	6,005,000	394,000	2,599,000	1,685,000	8,671,000
Acquisition Integration [Member]
Segment Reporting Information [Line Items]
Restructuring charges	1,622,000	606,000	94,000	(45,000)	(517,000)	(409,000)	2,322,000	(1,000,000)
Restructuring reserve	2,018,000	1,155,000	783,000	1,202,000	1,390,000	2,328,000	2,018,000	1,202,000	1,011,000	3,708,000
Legal Settlements [Member]
Segment Reporting Information [Line Items]
Restructuring charges	0	0	0	0	0	4,958,000		5,000,000
Payments for legal settlements								26,000,000
Restructuring reserve	$ 0	$ 0	$ 0	$ 0	$ 0	$ 5,000,000	$ 0	$ 0	$ 0	$ 26,000,000
Home Health [Member]
Segment Reporting Information [Line Items]
Number of branches divested								46