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Segment Reporting Segment Reporting - Selected Financial Information of Reportable Segments (Details) - USD ($) $ in Millions | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net operating revenues | $ 1,019.7 | $ 995.6 | $ 981.3 | $ 974.8 | $ 949.9 | $ 926.8 | $ 920.7 | $ 909.8 | $ 3,971.4 | $ 3,707.2 | $ 3,162.9
Less: Provision for doubtful accounts |  |  |  |  |  |  |  |  | (52.4) | (61.2) | (47.2)
Net operating revenues less provision for doubtful accounts |  |  |  |  |  |  |  |  | 3,919.0 | 3,646.0 | 3,115.7
Operating expenses: |  |  |  |  |  |  |  |  |  |  |
Salaries and benefits |  |  |  |  |  |  |  |  | 2,154.6 | 1,985.9 | 1,670.8
Other operating expenses |  |  |  |  |  |  |  |  | 536.7 | 492.1 | 432.1
Supplies |  |  |  |  |  |  |  |  | 149.3 | 140.0 | 128.7
Total segment level operating expenses |  |  |  |  |  |  |  |  | 3,269.6 | 2,997.2 | 2,569.0
Other income |  |  |  |  |  |  |  |  | (4.1) | (2.9) | (5.5)
Equity in net income of nonconsolidated affiliates |  |  |  |  |  |  |  |  | (8.0) | (9.8) | (8.7)
Noncontrolling interests | $ (25.9) | $ (19.2) | $ (16.4) | $ (17.6) | $ (16.8) | $ (16.4) | $ (18.6) | $ (18.7) | (79.1) | (70.5) | (69.7)
Inpatient Rehabilitation Segment [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net operating revenues |  |  |  |  |  |  |  |  | 3,188.1 | 3,021.1 | 2,653.1
Less: Provision for doubtful accounts |  |  |  |  |  |  |  |  | (46.8) | (57.0) | (44.7)
Net operating revenues less provision for doubtful accounts |  |  |  |  |  |  |  |  | 3,141.3 | 2,964.1 | 2,608.4
Operating expenses: |  |  |  |  |  |  |  |  |  |  |
Salaries and benefits |  |  |  |  |  |  |  |  | 1,603.8 | 1,493.4 | 1,310.6
Other operating expenses |  |  |  |  |  |  |  |  | 462.5 | 431.5 | 387.7
Supplies |  |  |  |  |  |  |  |  | 135.7 | 128.8 | 120.9
Occupancy costs |  |  |  |  |  |  |  |  | 61.9 | 61.2 | 46.2
Cost of services sold (excluding depreciation and amortization) |  |  |  |  |  |  |  |  | 0.0 | 0.0 | 0.0
Support and overhead costs |  |  |  |  |  |  |  |  | 0.0 | 0.0 | 0.0
Total segment level operating expenses |  |  |  |  |  |  |  |  | 2,263.9 | 2,114.9 | 1,865.4
Other income |  |  |  |  |  |  |  |  | (4.1) | (2.9) | (2.3)
Equity in net income of nonconsolidated affiliates |  |  |  |  |  |  |  |  | (7.3) | (9.1) | (8.6)
Noncontrolling interests |  |  |  |  |  |  |  |  | 67.6 | 64.0 | 62.9
Segment Adjusted EBITDA |  |  |  |  |  |  |  |  | 821.2 | 797.2 | 691.0
Capital expenditures |  |  |  |  |  |  |  |  | 238.0 | 198.3 | 151.7
Home Health and Hospice Segment [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net operating revenues |  |  |  |  |  |  |  |  | 783.3 | 686.1 | 509.8
Less: Provision for doubtful accounts |  |  |  |  |  |  |  |  | (5.6) | (4.2) | (2.5)
Net operating revenues less provision for doubtful accounts |  |  |  |  |  |  |  |  | 777.7 | 681.9 | 507.3
Operating expenses: |  |  |  |  |  |  |  |  |  |  |
Salaries and benefits |  |  |  |  |  |  |  |  | 0.0 | 0.0 | 0.0
Other operating expenses |  |  |  |  |  |  |  |  | 0.0 | 0.0 | 0.0
Supplies |  |  |  |  |  |  |  |  | 0.0 | 0.0 | 0.0
Occupancy costs |  |  |  |  |  |  |  |  | 0.0 | 0.0 | 0.0
Cost of services sold (excluding depreciation and amortization) |  |  |  |  |  |  |  |  | 368.4 | 336.5 | 244.8
Support and overhead costs |  |  |  |  |  |  |  |  | 277.2 | 237.2 | 172.7
Total segment level operating expenses |  |  |  |  |  |  |  |  | 645.6 | 573.7 | 417.5
Other income |  |  |  |  |  |  |  |  | 0.0 | 0.0 | 0.0
Equity in net income of nonconsolidated affiliates |  |  |  |  |  |  |  |  | (0.7) | (0.7) | (0.1)
Noncontrolling interests |  |  |  |  |  |  |  |  | 6.9 | 6.5 | 6.8
Segment Adjusted EBITDA |  |  |  |  |  |  |  |  | 125.9 | 102.4 | 83.1
Capital expenditures |  |  |  |  |  |  |  |  | $ 10.7 | $ 8.7 | $ 5.8

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