Operating Income of Reportable Segments (Detail) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Segment Reporting Information [Line Items]
Net service revenue	$ 301,639,000	$ 364,343,000	$ 947,165,000	$ 1,090,673,000
Cost of service, excluding depreciation and amortization	175,483,000	206,970,000	539,582,000	612,929,000
General and administrative expenses	116,000,000	126,700,000	357,900,000	387,800,000
Provision for doubtful accounts	3,971,000	5,487,000	12,531,000	15,788,000
Depreciation and amortization	10,471,000	9,771,000	32,152,000	29,375,000
U.S. Department of Justice settlement	150,000,000	0	150,000,000	0
Operating expenses	455,931,000	348,983,000	1,092,055,000	1,045,876,000
Operating (loss) income	(154,292,000)	15,360,000	(144,890,000)	44,797,000
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenue	237,100,000	290,200,000	750,600,000	873,900,000
Cost of service, excluding depreciation and amortization	140,900,000	168,900,000	435,300,000	500,700,000
General and administrative expenses	74,400,000	82,100,000	231,000,000	249,000,000
Provision for doubtful accounts	2,800,000	4,600,000	7,700,000	13,400,000
Depreciation and amortization	2,500,000	3,500,000	7,800,000	10,300,000
U.S. Department of Justice settlement	0		0
Operating expenses	220,600,000	259,100,000	681,800,000	773,400,000
Operating (loss) income	16,500,000	31,100,000	68,800,000	100,500,000
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenue	64,500,000	74,100,000	196,500,000	216,800,000
Cost of service, excluding depreciation and amortization	34,500,000	38,100,000	104,200,000	112,200,000
General and administrative expenses	16,100,000	18,800,000	49,200,000	53,200,000
Provision for doubtful accounts	1,200,000	900,000	4,800,000	2,400,000
Depreciation and amortization	500,000	500,000	1,600,000	1,100,000
U.S. Department of Justice settlement	0		0
Operating expenses	52,300,000	58,300,000	159,800,000	168,900,000
Operating (loss) income	12,200,000	15,800,000	36,700,000	47,900,000
All Other Segments [Member]
Segment Reporting Information [Line Items]
Net service revenue	0	0	0	0
Cost of service, excluding depreciation and amortization	0	0	0	0
General and administrative expenses	25,500,000	25,800,000	77,700,000	85,600,000
Provision for doubtful accounts	0	0	0	0
Depreciation and amortization	7,500,000	5,800,000	22,700,000	18,000,000
U.S. Department of Justice settlement	150,000,000		150,000,000
Operating expenses	183,000,000	31,600,000	250,400,000	103,600,000
Operating (loss) income	$ (183,000,000)	$ (31,600,000)	$ (250,400,000)	$ (103,600,000)