Acquisitions and Disposals - Additional Information (Detail) (USD $)	9 Months Ended
	Sep. 30, 2014 JointVenture	Sep. 30, 2013
Business Acquisition [Line Items]
Total purchase price for acquisitions	$ 74,700,000
Cash paid for acquisitions, primarily goodwill and intangible assets	73,194,000	26,920,000
Number of joint ventures in which ownership interest was sold	1
Proceeds from sale of additional ownership interests in joint ventures	200,000
Number of joint ventures in which additional ownership interests were acquired	2
Purchase price to acquire additional ownership interests in joint ventures	400,000
Home- Based Services
Business Acquisition [Line Items]
Number of entities acquired	44
Goodwill Recognized	43,800,000
General and Administrative Expense
Business Acquisition [Line Items]
Goodwill, including noncontrolling interest of $38	900,000
Hospice Services
Business Acquisition [Line Items]
Number of entities acquired	6
Goodwill Recognized	3,600,000
Deaconess HomeCare, LLC
Business Acquisition [Line Items]
Business acquisition, net revenues	35,100,000
Business acquisition, net income	$ 700,000
Minimum
Business Acquisition [Line Items]
Estimated useful life	2 years
Maximum
Business Acquisition [Line Items]
Estimated useful life	5 years