Goodwill and Other Intangible Assets Goodwill Changes (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014	Dec. 31, 2014
Goodwill [Line Items]
Acquisition of businesses, net of cash received			$ (54,802)	$ 0
Goodwill, Acquired During Period			32,441
Goodwill	$ 4,094,247		4,094,247		$ 4,061,806
Amortization of Intangible Assets	8,000	$ 8,000	16,000	$ 16,000
Long Term Care Group [Member]
Goodwill [Line Items]
Goodwill, Acquired During Period			32,441
Goodwill	3,603,810		3,603,810		3,571,369
specialty care group [Member]
Goodwill [Line Items]
Goodwill, Acquired During Period			0
Goodwill	$ 490,437		$ 490,437		$ 490,437