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Other Contingencies (Details) (USD $)
 1 Months Ended 12 Months Ended 1 Months Ended
Jul. 31, 2011
Dec. 31, 2013
financial_covenant
state
Jan. 31, 2013
Maximum [Member]
Jan. 31, 2013
Subsequent Event [Member]
Maximum [Member]
Dec. 31, 2013
Standby Letter of Credit [Member]
Jan. 02, 2014
Standby Letter of Credit [Member]
Subsequent Event [Member]
Short-term Debt [Line Items]            
Bank line of credit   $ 125,000,000        
Borrowings under line of credit   0        
Irrevocable standby letter of credit, outstanding         43,520,000 51,520,000
Reduction of bank line of credit   $ (43,520,000)        
Number of financial covenants   1        
Line of credit expiration date   Dec. 18, 2018        
Number of states in which entity operates   48        
Percentage of reduction to Medicare payments to nursing centers 11.10%          
Percentage of reduction of Medicare payments to plans and providers     2.00% 2.00%