Acquisitions and Joint Venture Activities - Almost Family Merger (Details) - USD ($) $ in Thousands	Apr. 01, 2018	Mar. 31, 2019	Dec. 31, 2018
Recognized amounts of identifiable assets acquired and liabilities assumed:
Preliminary goodwill		$ 1,164,999	$ 1,161,717
Almost Family
Business Acquisition [Line Items]
Stock	$ 795,412
Recognized amounts of identifiable assets acquired and liabilities assumed:
Cash and cash equivalents	16,547
Patient accounts receivable	89,635
Prepaid income taxes	47
Prepaid expenses and other current assets	11,490
Property and equipment	11,144
Customer relationships	13,970
Assets held for sale	2,500
Deferred income taxes	4,821
Accounts payable	(43,027)
Accrued other liabilities	(57,243)
Seller notes payable	(12,145)
NCI- Redeemable	(8,034)
Long term income taxes payable	(3,786)
Line of credit	(106,800)
NCI- Nonredeemable	(36,609)
Other assets and (liabilities), net	(178)
Total identifiable assets and liabilities	34,927
Preliminary goodwill	760,485
Almost Family | Trade name
Recognized amounts of identifiable assets acquired and liabilities assumed:
Indefinite-lived intangible assets	76,090
Almost Family | Certificates of need/licenses
Recognized amounts of identifiable assets acquired and liabilities assumed:
Indefinite-lived intangible assets	$ 76,505