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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, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net operating revenues | $ 1,096.0 | $ 1,067.6 | $ 1,067.7 | $ 1,046.0 | $ 1,008.8 | $ 981.6 | $ 966.4 | $ 957.1 | $ 4,277.3 | $ 3,913.9 | $ 3,642.6
Operating expenses: |  |  |  |  |  |  |  |  |  |  |
Salaries and benefits |  |  |  |  |  |  |  |  | 2,354.0 | 2,154.6 | 1,985.9
Other operating expenses |  |  |  |  |  |  |  |  | 585.1 | 531.6 | 490.6
Supplies |  |  |  |  |  |  |  |  | 158.7 | 149.3 | 140.0
Total segment level operating expenses |  |  |  |  |  |  |  |  | 3,647.7 | 3,264.5 | 2,993.8
Other income |  |  |  |  |  |  |  |  | (2.2) | (4.1) | (2.9)
Equity in net income of nonconsolidated affiliates |  |  |  |  |  |  |  |  | (8.7) | (8.0) | (9.8)
Noncontrolling interests | $ (19.6) | $ (20.7) | $ (21.4) | $ (21.4) | $ (25.9) | $ (19.2) | $ (16.4) | $ (17.6) | (83.1) | (79.1) | (70.5)
Inpatient Rehabilitation Segment [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net operating revenues |  |  |  |  |  |  |  |  | 3,346.2 | 3,141.3 | 2,964.1
Operating expenses: |  |  |  |  |  |  |  |  |  |  |
Salaries and benefits |  |  |  |  |  |  |  |  | 1,701.5 | 1,603.8 | 1,493.4
Other operating expenses |  |  |  |  |  |  |  |  | 502.3 | 462.5 | 431.5
Supplies |  |  |  |  |  |  |  |  | 140.6 | 135.7 | 128.8
Occupancy costs |  |  |  |  |  |  |  |  | 63.8 | 61.9 | 61.2
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 |  |  |  |  |  |  |  |  | 2,408.2 | 2,263.9 | 2,114.9
Other income |  |  |  |  |  |  |  |  | (3.6) | (4.1) | (2.9)
Equity in net income of nonconsolidated affiliates |  |  |  |  |  |  |  |  | (7.5) | (7.3) | (9.1)
Noncontrolling interests |  |  |  |  |  |  |  |  | 77.2 | 67.6 | 64.0
Segment Adjusted EBITDA |  |  |  |  |  |  |  |  | 871.9 | 821.2 | 797.2
Capital expenditures |  |  |  |  |  |  |  |  | 264.6 | 238.0 | 198.3
Home Health and Hospice Segment [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net operating revenues |  |  |  |  |  |  |  |  | 931.1 | 772.6 | 678.5
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) |  |  |  |  |  |  |  |  | 438.4 | 363.3 | 333.1
Support and overhead costs |  |  |  |  |  |  |  |  | 323.5 | 277.2 | 237.2
Total segment level operating expenses |  |  |  |  |  |  |  |  | 761.9 | 640.5 | 570.3
Other income |  |  |  |  |  |  |  |  | (0.5) | 0.0 | 0.0
Equity in net income of nonconsolidated affiliates |  |  |  |  |  |  |  |  | (1.2) | (0.7) | (0.7)
Noncontrolling interests |  |  |  |  |  |  |  |  | 8.5 | 6.9 | 6.5
Segment Adjusted EBITDA |  |  |  |  |  |  |  |  | 162.4 | 125.9 | 102.4
Capital expenditures |  |  |  |  |  |  |  |  | $ 11.6 | $ 10.7 | $ 8.7

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