Leases - Additional information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)
Number Of License Lease Arrangements	3
Home nursing agencies	4
Hospice agencies	3
Operating Leases Start Period	2007
Operating Leases Expiration Period	2017
Operating Leases, Rent Expense	$ 20,700	$ 21,100	$ 17,200
Operating Lease Period Minimum	3 years
Operating Lease Period Maximum	10 years
Operating Leases, Future Minimum Payments Due, Next Twelve Months	$ 25,207
Minimum Miles Required per Year for the Fleet Lease	12,000
Minimum Period of the Fleet Lease	12 months
Fleet Lease's Expense	$ 7,200	3,600
Lease Agreement For License	$ 500	$ 400
Minimum [Member]
Operating Lease Period	1 year
Maximum [Member]
Operating Lease Period	4 years
Lease 1 [Member]
Operating Leases, Future Minimum Payments Due, Next Twelve Months	$ 200
Lease Agreement For License	$ 200
Lease 2 [Member]
Lease Agreement For License			$ 300