Goodwill and Intangibles (Details Textual) (USD $) In Thousands, unless otherwise specified	6 Months Ended
Jun. 30, 2012	Dec. 31, 2011
Goodwill and Intangibles (Textual) [Abstract]
Other intangible assets net of accumulated amotization	$ 60,702	$ 59,389
Goodwill and Intangibles (Additional Textual) [Abstract]
Intangible assets acquired	1,700
Noncompeting agreement will be amortized over the life of agreement	3 years
Home Based Services [Member]
Goodwill and Intangibles (Textual) [Abstract]
Other intangible assets net of accumulated amotization	59,200
Facility Based Services [Member]
Goodwill and Intangibles (Textual) [Abstract]
Other intangible assets net of accumulated amotization	$ 1,500

Sum of the carrying amounts of all intangible assets, excluding goodwill, as of the balance sheet date, net of accumulated amortization and impairment charges.

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 350

-SubTopic 30

-Section 45

-Paragraph 1

-URI http://asc.fasb.org/extlink&oid=6388964&loc=d3e16212-109274

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 350

-SubTopic 30

-Section 50

-Paragraph 2

-Subparagraph ((a)(1),(b))

-URI http://asc.fasb.org/extlink&oid=7658586&loc=d3e16323-109275

Reference 3: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Statement of Financial Accounting Standard (FAS)

-Number 142

-Paragraph 42, 45

-LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy.

Name:	us-gaap_IntangibleAssetsNetExcludingGoodwill
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	instant