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Segment Reporting Segment Reporting - Reconciliation of Adjusted EBITDA (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, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
General and administrative expenses									$ (220.2)	$ (171.7)	$ (133.4)
Depreciation and amortization									(199.7)	(183.8)	(172.6)
Government, class action, and related settlements									(52.0)	0.0	0.0
Loss on early extinguishment of debt									0.0	(10.7)	(7.4)
Net income attributable to noncontrolling interests	$ 19.6	$ 20.7	$ 21.4	$ 21.4	$ 25.9	$ 19.2	$ 16.4	$ 17.6	83.1	79.1	70.5
Income from continuing operations before income tax expense									493.2	496.4	482.0
Inpatient Rehabilitation Hospital and Home Health and Hospice [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Total segment Adjusted EBITDA									1,034.3	947.1	899.6
Segment Reconciling Items [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
General and administrative expenses									(220.2)	(171.7)	(133.4)
Depreciation and amortization									(199.7)	(183.8)	(172.6)
Loss on disposal of assets									(5.7)	(4.6)	(0.7)
Government, class action, and related settlements									(52.0)	0.0	0.0
Professional fees—accounting, tax, and legal									0.0	0.0	(1.9)
Loss on early extinguishment of debt									0.0	(10.7)	(7.4)
Interest expense and amortization of debt discounts and fees									(147.3)	(154.4)	(172.1)
Net income attributable to noncontrolling interests									83.1	79.1	70.5
SARs mark-to-market impact on noncontrolling interests									2.6	0.0	0.0
Change in fair market value of equity securities									(1.9)	0.0	0.0
Tax reform impact on noncontrolling interests									$ 0.0	$ (4.6)	$ 0.0