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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