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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