Identifiable Intangible Assets and Goodwill (Details) (USD $) In Thousands, unless otherwise specified																									9 Months Ended
	Sep. 30, 2013	Dec. 31, 2012	Sep. 30, 2013 Home Health [Member]	Dec. 31, 2012 Home Health [Member]	Sep. 30, 2013 Hospice [Member]	Dec. 31, 2012 Hospice [Member]	Sep. 30, 2013 Medicare licenses and certificates of need [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member]	Sep. 30, 2013 Medicare licenses and certificates of need [Member] Home Health [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member] Home Health [Member]	Sep. 30, 2013 Medicare licenses and certificates of need [Member] Hospice [Member]	Dec. 31, 2012 Medicare licenses and certificates of need [Member] Hospice [Member]	Sep. 30, 2013 Covenants not to compete [Member]	Dec. 31, 2012 Covenants not to compete [Member]	Sep. 30, 2013 Covenants not to compete [Member] Home Health [Member]	Dec. 31, 2012 Covenants not to compete [Member] Home Health [Member]	Sep. 30, 2013 Covenants not to compete [Member] Hospice [Member]	Dec. 31, 2012 Covenants not to compete [Member] Hospice [Member]	Sep. 30, 2013 Customer Relationships [Member]	Dec. 31, 2012 Customer Relationships [Member]	Sep. 30, 2013 Customer Relationships [Member] Home Health [Member]	Dec. 31, 2012 Customer Relationships [Member] Home Health [Member]	Sep. 30, 2013 Customer Relationships [Member] Hospice [Member]	Dec. 31, 2012 Customer Relationships [Member] Hospice [Member]	Sep. 30, 2013 Maximum [Member] Covenants not to compete [Member]	Sep. 30, 2013 Maximum [Member] Customer Relationships [Member]	Sep. 30, 2013 Minimum [Member] Covenants not to compete [Member]	Sep. 30, 2013 Minimum [Member] Customer Relationships [Member]
Amortized intangible assets:
Finite-Lived Intangible Assets, Gross													$ 17,352	$ 17,352	$ 1,667	$ 1,667	$ 15,685	$ 15,685	$ 28,106	$ 28,106	$ 27,196	$ 27,196	$ 910	$ 910
Less: Accumulated Amortization													(17,174)	(15,562)	(1,496)	(1,449)	(15,678)	(14,113)	(19,869)	(18,041)	(19,411)	(17,651)	(458)	(390)
Finite Lived Intangible Assets, Accumulated Impairment																			(27)	(27)	(27)	(27)	0	0
Finite-Lived Intangible Assets, Net	8,388	11,828	7,929	9,736	459	2,092							178	1,790	171	218	7	1,572	8,210	10,038	7,758	9,518	452	520
Finite-Lived Intangible Asset, useful life																									5 years	10 years	2 years	5 years
Indefinite-lived intangible assets:
Indefinite-Lived Intangible Assets							330,038	326,976	227,799	225,227	102,239	101,749
Indefinite Lived Intangible Assets, Accumulated Impairment							(145,191)	(145,191)	(144,672)	(144,672)	(519)	(519)
Indefinite Lived Intangible Assets, Net							184,847	181,785	83,127	80,555	101,720	101,230
Total identifiable intangible assets	$ 193,235	$ 193,613	$ 91,056	$ 90,291	$ 102,179	$ 103,322