Business Segment Information (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Segment net revenues by major payer source
Total net revenues	$ 410,492	$ 424,444	$ 1,240,507	$ 1,287,787
Medicare [Member]
Segment net revenues by major payer source
Total net revenues	355,600	362,400	1,076,500	1,100,700
Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	17,400	19,100	54,400	56,900
Commercial Insurance and Other [Member]
Segment net revenues by major payer source
Total net revenues	37,500	42,900	109,700	130,200
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	15,100	21,400	43,300	62,800
Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues	22,400	21,500	66,300	67,400
Home Health [Member]
Segment net revenues by major payer source
Total net revenues	234,900	234,700	706,100	710,300
Home Health [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues	191,800	185,000	577,700	561,700
Home Health [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	10,800	12,200	33,100	35,700
Home Health [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	15,100	21,400	43,300	62,800
Home Health [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues	17,200	16,100	52,000	50,100
Hospice [Member]
Segment net revenues by major payer source
Total net revenues	175,600	189,700	534,400	577,500
Hospice [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues	163,800	177,400	498,800	539,000
Hospice [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	6,600	6,900	21,300	21,200
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	0
Hospice [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues	$ 5,200	$ 5,400	$ 14,300	$ 17,300