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Other Contingencies - Additional Information (Detail) (USD $)
1 Months Ended 9 Months Ended
Jul. 31, 2011
Sep. 30, 2012
State
Other Contingencies [Line Items]    
Bank line of credit   $ 57,000,000
Borrowings under line of credit   0
Irrevocable standby letter of credit, outstanding   $ 40,420,000
Line of credit expiration date   Jun. 30, 2013
Number of states in which entity operates   48
Percent reduction of Medicare payments to nursing centers 11.10%