Goodwill and Intangibles - Additional Information (Detail) (USD $) In Thousands, unless otherwise specified	Sep. 30, 2014	Dec. 31, 2013
Indefinite-lived Intangible Assets [Line Items]
Intangible assets net of accumulated amortization	$ 79,988	$ 62,184
Home- Based Services
Indefinite-lived Intangible Assets [Line Items]
Intangible assets net of accumulated amortization	74,000
Hospice Services
Indefinite-lived Intangible Assets [Line Items]
Intangible assets net of accumulated amortization	5,000
Facility- Based Services
Indefinite-lived Intangible Assets [Line Items]
Intangible assets net of accumulated amortization	$ 1,000