Almost Family Merger - Pro Forma Schedule (Details) - Almost Family - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	9 Months Ended
Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Business Acquisition [Line Items]
Net service revenue	$ 507,043	$ 460,284	$ 1,504,087	$ 1,357,111
Net income attributable to the Company	$ 21,230	$ 14,076	$ 58,882	$ 43,257
Diluted earnings per share (in usd per share)	$ 0.68	$ 0.84	$ 1.89	$ 1.39

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