Identifiable Intangible Assets and Goodwill (Details 1) (USD $) In Thousands, unless otherwise specified	9 Months Ended	12 Months Ended
	Sep. 30, 2013	Dec. 31, 2012	Dec. 31, 2011
Goodwill [Roll Forward]
Goodwill, Gross	$ 1,116,273	$ 1,113,401	$ 1,098,706
Goodwill, Impaired, Accumulated Impairment Loss	(677,837)	(457,037)	(457,037)
Goodwill, Acquired During Period	2,872	14,695
Goodwill, Impairment Loss	(220,800)
Home Health [Member]
Goodwill [Roll Forward]
Goodwill, Gross	275,079	272,389	267,058
Goodwill, Impaired, Accumulated Impairment Loss	(263,370)	(263,370)	(263,370)
Goodwill, Acquired During Period	2,690	5,331
Goodwill, Impairment Loss	0
Hospice [Member]
Goodwill [Roll Forward]
Goodwill, Gross	841,194	841,012	831,648
Goodwill, Impaired, Accumulated Impairment Loss	(414,467)	(193,667)	(193,667)
Goodwill, Acquired During Period	182	9,364
Goodwill, Impairment Loss	$ (220,800)