Goodwill and Intangibles - Additional Information (Detail) (USD $)	3 Months Ended	9 Months Ended
	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Dec. 31, 2012
Indefinite-lived Intangible Assets [Line Items]
Intangible assets net of accumulated amortization		$ 63,199,000		$ 62,042,000
Impairment of goodwill		0
Impairment of intangible assets	650,000		650,000
Home-based services [Member]
Indefinite-lived Intangible Assets [Line Items]
Intangible assets net of accumulated amortization		62,100,000
Impairment of intangible assets	250,000		250,000
Facility-based services [Member]
Indefinite-lived Intangible Assets [Line Items]
Intangible assets net of accumulated amortization		1,100,000
Impairment of intangible assets	$ 400,000		$ 400,000