National Mentor (NMH) 10-Q 14 May 14 2014 Q2 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	6 Months Ended
	Mar. 31, 2014	14-May-14
Document And Entity Information [Abstract]	'	'
Document Type	'10-Q	'
Amendment Flag	'false	'
Document Period End Date	31-Mar-14	'
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q2	'
Entity Registrant Name	'NATIONAL MENTOR HOLDINGS, INC.	'
Entity Central Index Key	'0001338690	'
Current Fiscal Year End Date	'--09-30	'
Entity Filer Category	'Non-accelerated Filer	'
Entity Common Stock, Shares Outstanding	'	100

Condensed_Consolidated_Balance

Condensed Consolidated Balance Sheets (USD $)	Mar. 31, 2014	Sep. 30, 2013
In Thousands, unless otherwise specified
Current assets:	'	'
Cash and cash equivalents	$19,920	$19,315
Restricted cash	1,947	807
Accounts receivable, net	140,243	144,954
Deferred tax assets, net	17,878	18,424
Prepaid expenses and other current assets	19,448	17,771
Total current assets	199,436	201,271
Property and equipment, net	153,420	153,635
Intangible assets, net	325,862	336,191
Goodwill	238,409	235,623
Restricted cash	50,000	50,000
Other assets	38,924	43,652
Total assets	1,006,051	1,020,372
Current liabilities:	'	'
Accounts payable	18,882	26,568
Accrued payroll and related costs	66,534	65,340
Other accrued liabilities	41,891	45,066
Obligations under capital lease, current	446	430
Current portion of long-term debt	6,000	5,600
Total current liabilities	133,753	143,004
Other long-term liabilities	62,830	68,936
Deferred tax liabilities, net	80,118	83,235
Obligations under capital lease, less current portion	6,289	6,509
Long-term debt, less current portion	799,312	779,519
Commitments and contingencies	'	'
SHAREHOLDER'S DEFICIT	'	'
Common stock	'	'
Additional paid-in capital	33,900	33,929
Accumulated other comprehensive loss	-1,061	-1,880
Accumulated deficit	-109,090	-92,880
Total shareholder's deficit	-76,251	-60,831
Total liabilities and shareholder's deficit	$1,006,051	$1,020,372

Condensed_Consolidated_Stateme

Condensed Consolidated Statements of Operations (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013
Income Statement [Abstract]	'	'	'	'
Net revenue	$309,815	$295,571	$617,297	$589,207
Cost of revenue (exclusive of depreciation expense shown below)	242,483	232,053	484,335	465,775
Operating expenses:	'	'	'	'
General and administrative	35,660	37,209	72,141	73,865
Depreciation and amortization	16,605	15,637	32,670	31,145
Total operating expenses	52,265	52,846	104,811	105,010
Income from operations	15,067	10,672	28,151	18,422
Other income (expense):	'	'	'	'
Management fee of related party	-354	-329	-699	-665
Other income, net	31	397	377	735
Extinguishment of debt	-14,699	'	-14,699	'
Interest income	108	71	137	76
Interest expense	-17,451	-19,342	-36,952	-38,947
Loss from continuing operations before income taxes	-17,298	-8,531	-23,685	-20,379
Benefit for income taxes	-5,779	-3,285	-7,453	-6,784
Loss from continuing operations	-11,519	-5,246	-16,232	-13,595
Gain (loss) from discontinued operations, net of tax	-1	-2,589	22	-2,614
Net loss	($11,520)	($7,835)	($16,210)	($16,209)

Condensed_Consolidated_Stateme1

Condensed Consolidated Statements of Comprehensive Loss (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013
Amounts Reclassified Out Of Accumulated Other Comprehensive Income Loss [Abstract]	'	'	'	'
Net loss	($11,520)	($7,835)	($16,210)	($16,209)
Other comprehensive loss, net of tax:	'	'	'	'
Gain on derivative instrument net of tax for the three and six months ended March 31, 2014 of $236 and $546, respectively, and $227 and $448 for the three and six months ended March 31, 2013, respectively	353	343	819	608
Comprehensive loss	($11,167)	($7,492)	($15,391)	($15,601)

Condensed_Consolidated_Stateme2

Condensed Consolidated Statements of Comprehensive Loss (Parenthetical) (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013
Amounts Reclassified Out Of Accumulated Other Comprehensive Income Loss [Abstract]	'	'	'	'
Tax effects of changes in unrealized gain on derivatives	$236	$227	$546	$448

Condensed_Consolidated_Stateme3

Condensed Consolidated Statements of Cash Flows (USD $)	6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Operating activities	'	'
Net loss	($16,210)	($16,209)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:	'	'
Accounts receivable allowances	7,919	7,418
Depreciation and amortization of property and equipment	13,639	12,472
Amortization of intangible assets	19,030	18,834
Amortization and write-off of original issue discount and initial purchasers discount	6,218	1,474
Amortization and write-off of financing costs	8,903	1,410
Stock-based compensation	58	233
Deferred income taxes	-2,881	-6,104
Loss on disposal of assets	-348	77
Non-cash impairment charge	'	4,158
Changes in operating assets and liabilities:	'	'
Accounts receivable	-3,208	-6,893
Other assets	5,072	-4,610
Accounts payable	-7,259	-5,813
Accrued payroll and related costs	1,194	-6,618
Other accrued liabilities	-1,638	-2,537
Other long-term liabilities	-6,106	9,648
Net cash provided by operating activities	24,383	6,940
Investing activities	'	'
Cash paid for acquisitions, net of cash received	-11,828	-475
Purchases of property and equipment	-14,358	-15,375
Changes in restricted cash	-1,140	331
Proceeds from sale of assets	787	788
Net cash used in investing activities	-26,539	-14,731
Financing activities	'	'
Repayments of long-term debt	-584,525	-2,725
Proceeds from borrowings under senior revolver	9,300	448,900
Repayments of borrowings under senior revolver	-9,300	-462,700
Issuance of debt	598,500	30,000
Repayments of capital lease obligations	-204	-205
Dividend to parent	-87	-26
Payments of financing costs	-10,923	-2,048
Net cash provided by financing activities	2,761	11,196
Net increase in cash and cash equivalents	605	3,405
Cash and cash equivalents at beginning of period	19,315	'
Cash and cash equivalents at end of period	19,920	3,405
Supplemental disclosure of cash flow information	'	'
Cash paid for interest	34,499	35,638
Cash paid for income taxes	483	471
Supplemental disclosure of non-cash investing activities:	'	'
Accrued property, plant and equipment	$472	$530

Basis_of_Presentation

Basis of Presentation	6 Months Ended
	Mar. 31, 2014
Accounting Policies [Abstract]	'
Basis of Presentation	'
	1. Basis of Presentation
	National Mentor Holdings, Inc., through its wholly owned subsidiaries (collectively, the “Company”), is a leading provider of home and community-based health and human services to adults and children with intellectual and/or developmental disabilities, acquired brain injury and other catastrophic injuries and illnesses; and to youth with emotional, behavioral and/or medically complex challenges. Since the Company’s founding in 1980, the Company’s operations have grown to 36 states. The Company provides residential services to approximately 12,500 clients, some of whom also receive periodic services. Approximately 16,100 clients receive periodic services from the Company in non-residential settings.
	The Company designs customized service plans to meet the unique needs of its clients, which it delivers in home- and community-based settings. Most of the Company’s service plans involve residential support, typically in small group homes, host home settings, or specialized community facilities, designed to improve the clients’ quality of life and to promote their independence and participation in community life. Other services offered include supported living, day and transitional programs, vocational services, case management, family-based and outpatient therapeutic services, post-acute treatment and neurorehabilitation, neurobehavioral rehabilitation and physical, occupational and speech therapies, among others. The Company’s customized service plans offer its clients as well as the payors of these services, an attractive, cost-effective alternative to health and human services provided in large, institutional settings.
	The accompanying unaudited condensed consolidated financial statements have been prepared by the Company in accordance with generally accepted accounting principles (“GAAP”) for interim financial information and pursuant to the applicable rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. The unaudited condensed consolidated financial statements herein should be read in conjunction with the Company’s audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended September 30, 2013, which is on file with the SEC. In the opinion of management, the accompanying unaudited condensed consolidated financial statements contain all adjustments, consisting of normal and recurring accruals, necessary to present fairly the financial statements in accordance with GAAP. Intercompany balances and transactions between the Company and its subsidiaries have been eliminated in consolidation. Operating results for the three and six months ended March 31, 2014 may not necessarily be indicative of results to be expected for any other interim period or for the full year.
	The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates.

Recent_Accounting_Pronouncemen

Recent Accounting Pronouncements	6 Months Ended
	Mar. 31, 2014
Accounting Changes And Error Corrections [Abstract]	'
Recent Accounting Pronouncements	'
	2. Recent Accounting Pronouncements
	Technical Corrections and Improvements — In October 2012, the FASB issued Accounting Standards Update No. 2012-04, Technical Corrections and Improvements (“ASU 2012-04”). The amendments in this update cover a wide range of Topics in the Accounting Standards Codification. These amendments include technical corrections and improvements to the Accounting Standards Codification and conforming amendments related to fair value measurements. The amendments in this update were effective for the Company beginning the first quarter of the fiscal year ending September 30, 2014. This adoption did not have a material impact on the Company’s consolidated financial statements.
	Technical Corrections and Improvements Related to Glossary Terms – In March 2014, the FASB issued Accounting Standards Update No. 2014-06, Technical Corrections and Improvements Related to Glossary Terms (“ASU 2014-06”). The amendments in this Update relate to glossary terms and cover a wide range of Topics in the Codification. The amendments in this Update were effective for the Company beginning the second quarter of the fiscal year ending September 30, 2014. This adoption did not have a material impact on the Company’s consolidated financial statements.

LongTerm_Debt

Long-Term Debt	6 Months Ended
	Mar. 31, 2014
Debt Disclosure [Abstract]	'
Long-Term Debt	'
	3. Long-Term Debt
	As of March 31, 2014 and September 31, 2013, the Company’s long-term debt consisted of the following:
	(in thousands)	March 31,			September 30,
		2014			2013
	Term loan principal and interest due in quarterly installments through January 31, 2021, subject to acceleration to November 15, 2017	$	600,000		$	—
	Prior term loan, principal and interest repaid on January 31, 2014		—			546,525
	Original issue discount on term loan, net of accumulated amortization		(1,432	)		(4,403	)
	Senior notes, due February 15, 2018; semi-annual cash interest payments due each February 15th and August 15th (interest rate of 12.50%)		212,000			250,000
	Original issue discount and initial purchase discount on senior notes, net of accumulated amortization		(5,256	)		(7,003	)
			805,312			785,119
	Less current portion		6,000			5,600
	Long-term debt	$	799,312		$	779,519
	On January 31, 2014, the Company completed a refinancing transaction by entering into the senior secured credit facilities consisting of a term loan facility and a senior revolver. In connection with the refinancing transaction, the prior senior secured credit facilities were repaid and replaced with the senior secured credit facilities. The Company incurred $11.1 million of expenses related to the refinancing transaction including $7.2 million related to the write-off of deferred financing costs and $3.9 million related to the write-off of original issue discount related to the prior indebtedness. These expenses are recorded on the Company’s consolidated statement of operations as Extinguishment of debt.
	On February 26, 2014, the Company redeemed $38.0 million aggregate principal amount of the outstanding senior notes, in accordance with the provisions of the indenture governing the senior notes. In connection with the partial redemption of the senior notes, the Company incurred $3.6 million of expenses including $2.4 million related to redemption premium, $1.0 million related to the write-off of original issue discount and initial purchase discount, and $0.2 million related to the write-off of deferred financing costs. These expenses are recorded on the Company’s consolidated statement of operations as Extinguishment of debt.
	At September 30, 2013, the Company had $785.1 million of indebtedness, consisting of $546.5 million of indebtedness under the prior term loan and incremental term loan facilities and unamortized original issue discount of $4.4 million, $250.0 million aggregate principal amount of the 12.5% senior notes due 2018 (the “senior notes”) and unamortized original issue discount and initial purchase discount of $7.0 million. As of September 30, 2013, the Company did not have any borrowing under the prior senior revolving credit facility (the “prior senior revolver”).
	Senior Secured Credit Facilities
	On January 31, 2014, the Company and NMH Holdings, LLC (“Parent”) entered into a new senior credit agreement (the “senior credit agreement”) with Barclays Bank PLC, as administrative agent, and the other agents and lenders named therein, for the new senior secured credit facilities (the “senior secured credit facilities”), consisting of a $600.0 million term loan facility (the “term loan facility”), of which $50.0 million was deposited in a cash collateral account in support of issuance of letters of credit under an institutional letter of credit facility (the “institutional letter of credit facility”), and a $100.0 million senior secured revolving credit facility (the “senior revolver”). The term loan facility has a seven-year maturity and the senior revolver has a five-year maturity; provided, that if the Company’s senior notes due 2018 are not refinanced in full on or prior to the date that is three months prior to February 15, 2018, such maturity dates shall spring forward to November 15, 2017. The senior credit agreement provides that the Company may make one or more offers to the lenders, and consummate transactions with individual lenders that accept the terms contained in such offers, to extend the maturity date of the lender’s term loans and/or revolving commitments, subject to certain conditions, and any extended term loans or revolving commitments will constitute a separate class of term loans or revolving commitments.
	All of the Company’s obligations under the senior secured credit facilities are guaranteed by Parent and the subsidiary guarantors named therein (the “Subsidiary Guarantors”). Pursuant to the Guarantee and Security Agreement, dated as of January 31, 2014 (the “guarantee and security agreement”), among Parent, as parent guarantor, the Company, certain subsidiaries of the Company, as subsidiary guarantors and Barclays Bank, PLC, as administrative agent, subject to certain exceptions, the obligations under the senior secured credit facilities are secured by a pledge of 100% of the Company’s capital stock and the capital stock of certain domestic subsidiaries and a security interest in substantially all of the Company’s tangible and intangible assets and the tangible and intangible assets of Parent and each Subsidiary Guarantor.
	Borrowings under the senior secured credit facilities bear interest, at the Company’s option, at: (i) an ABR rate equal to the greater of (a) the prime rate of Barclays Bank PLC, (b) the federal funds rate plus 1/2 of 1.0%, and (c) the Eurodollar rate for an interest period of one-month beginning on such day plus 100 basis points, plus 2.75% (provided that the ABR rate applicable to the term loan facility will not be less than 2.00% per annum); or (ii) the Eurodollar rate (provided that the Eurodollar rate applicable to the term loan facility will not be less than 1.00% per annum), plus 3.75%. The Company is also required to pay a commitment fee to the lenders under the senior revolver at an initial rate of 0.50% of the average daily unutilized commitments thereunder. The Company must also pay customary letter of credit fees.
	Term loan
	As of March 31, 2014, the Company had $600 million of borrowings under the term loan. At March 31, 2014, the variable interest rate on the term loan was 4.75%.
	The senior credit agreement requires us to make mandatory prepayments, subject to certain exceptions, with: (i) beginning in fiscal year 2015, 50% (which percentage will be reduced upon our achievement of certain first lien leverage ratios) of our annual excess cash flow (as defined in the senior credit agreement); (ii) 100% of net cash proceeds of all non-ordinary course assets sales or other dispositions of property, subject to certain exceptions and thresholds; and (iii) 100% of the net cash proceeds of any debt incurrence, other than debt permitted under the senior credit agreement. We are required to repay the term loan facility portion of the senior secured credit facilities in quarterly principal installments of 0.25% of the principal amount commencing on June 30, 2014, with the balance payable at maturity. The senior credit agreement permits us to offer to the lenders newly issued notes in exchange for their term loans in one or more permitted debt exchange offers, subject to the conditions set forth in the senior credit agreement. In addition, if, on or prior to July 31, 2014, we prepay or reprice any portion of the term loan facility, we will be required to pay a prepayment premium of 1% of the loans being prepaid or repriced.
	Prior term loan
	The prior term loan was issued at a price equal to 98.5% of its face value. The prior senior credit agreement also included an annual provision for the prepayment of a portion of the outstanding term loan amounts beginning in fiscal 2011 equal to an amount ranging from 0 to 50% of a calculated amount, depending on the Company’s leverage ratio, if the Company generated certain levels of cash flow. The Company was not required to make such a prepayment of its prior term loan. The Company was required to repay the prior term loan in quarterly principal installments of 0.25% of the original principal amount, with the balance payable at maturity.
	Senior revolver
	During the six months ended March 31, 2014, the Company drew $9.3 million under the senior revolver and repaid $9.3 million during the period. At March 31, 2014, the Company had no outstanding borrowings under the senior revolver and $100.0 million of availability under the senior revolver. The Company had $44.7 million of standby letters of credit issued under the institutional letter of credit facility primarily related to the Company’s workers’ compensation insurance coverage. The Company’s institutional letter of credit facility provided for the issuance of letters of credit up to the $50.0 million limit, and letters of credit in excess of that amount reduced availability under the Company’s senior revolver. The interest rate for borrowings under the senior revolver was 6.0% as of March 31, 2014.
	The senior revolver includes borrowing capacity available for borrowings on same-day notice, referred to as the “swingline loans.” Any swingline loans or other borrowings under the senior revolver would have maturities less than one year, and would be reflected under Current portion of long-term debt on the Company’s consolidated balance sheets.
	Prior senior revolver
	The prior senior revolver provided for borrowings of up to $75.0 million.
	Senior Notes
	In February 2011, the Company issued $250.0 million of 12.5% senior notes due 2018 (the “senior notes”) at a price equal to 97.7% of their face value, for net proceeds of $244.3 million. The net proceeds were further reduced by an initial purchasers’ discount of $5.6 million. The senior notes are the Company’s unsecured obligations and are guaranteed by certain of the Company’s existing subsidiaries.
	The Company redeemed $38 million aggregate principal amount of the outstanding senior notes on February 26, 2014, in accordance with the provisions of the indenture governing the senior notes. The redemption price of the senior notes was 106.250% of the principal amount redeemed, plus accrued and unpaid interest to, but not including, the redemption date.
	Covenants
	The senior credit agreement and indenture governing the senior notes contain negative covenants, including, among other things, limitations on the Company’s ability to incur additional debt, transfer or sell assets, pay dividends, redeem stock or make other distributions or investments, and engage in certain transactions with affiliates. The senior credit agreement contains a springing financial covenant that requires the Company to maintain a specified consolidated leverage ratio in the event the Company borrows in excess of 30% of its senior revolver commitment if, at the end of any fiscal quarter our usage of the senior revolver exceeds 30% of the commitments thereunder, we are required to maintain at the end of each such fiscal quarter, commencing with the quarter ending June 30, 2014, a consolidated first lien leverage ratio of not more than 5.50 to 1.00. This consolidated first lien leverage ratio will step down to 5.00 to 1.00 commencing with the fiscal quarter ending March 31, 2017. The springing financial covenant was not in effect as of March 31, 2014 as our usage of the senior revolver did not exceed the threshold for the quarter ended March 31, 2014.
	The Company is restricted from paying dividends to Parent in excess of $15.0 million, except for dividends used for the repurchase of equity from former officers and employees and for the payment of management fees, taxes, and certain other exceptions.
	Derivatives
	The Company entered into an interest rate swap in a notional amount of $400.0 million effective March 31, 2011, maturing on September 30, 2014. The Company entered into this interest rate swap to hedge the risk of changes in the floating rate of interest on borrowings under the term loan.
	On October 15, 2012, the Company amended the terms of its interest rate swap agreement in connection with the amendment and restatement of the terms of the old senior secured credit facilities. The notional amount of the interest rate swap of $400.0 million and maturity date of September 30, 2014 remained unchanged. Under the new terms of the interest rate swap, the Company receives from the counterparty a quarterly payment based on a rate equal to the greater of 3-month LIBOR and 1.25% per annum, and the Company makes payments to the counterparty based on a fixed rate of 2.08% per annum, in each case on the notional amount of $400.0 million, settled on a net payment basis. Based on the applicable margin of 5.25% under the Company’s prior term loan, this swap effectively fixed the Company’s cost of borrowing for $400.0 million of the old term loan at 7.3% per annum for the term of the swap. As a result of the modification of the terms of the interest rate swap agreement, the fair value of the interest rate swap was increased by $68 thousand and the increase in fair value is being amortized into Other income (expense) over the remaining term of the interest rate swap agreement.
	Prior to the January 31, 2014 refinancing transaction, the Company accounted for the interest rate swap as a cash flow hedge and the effectiveness of the hedge relationship was assessed on a quarterly basis. The fair value of the swap agreement, representing the price that would be paid to transfer the liability in an orderly transaction between market participants, was recorded in current liabilities (under Other accrued liabilities) and was determined based on pricing models and independent formulas using current assumptions. The change in fair market value was recorded in the consolidated statements of comprehensive loss.
	In conjunction with the January 31, 2014 refinancing transaction, the Company de-designated the interest rate swap agreement as a cash flow hedge. Subsequent to the January 31, 2014 refinancing transaction, prospective mark to market adjustments will be recognized in earnings and accumulated mark to market adjustments are being amortized and recognized in earnings over the term of the interest rate swap agreement which matures on September 30, 2014. For the three months and six months ending March 31, 2014, the Company recognized $0.6 million of interest expense, related to the amortization of the previously mark to market adjustments. As of March 31, 2014, the unamortized historical mark to market adjustments balance was $1.1 million net of tax effect of $0.7 million.

Shareholders_Equity

Shareholder's Equity	6 Months Ended
	Mar. 31, 2014
Equity [Abstract]	'
Shareholder's Equity	'
	4. Shareholder’s Equity
	Common Stock
	The holders of the Company’s common stock are entitled to receive dividends when and as declared by the Company’s Board of Directors. In addition, the holders of common stock are entitled to one vote per share. All of the outstanding shares of common stock are held by Parent.
	Dividends to Parent
	During the second quarter of fiscal 2014 and 2013, our indirect parent NMH Investment, LLC repurchased equity units from employees upon or after their departures from the Company of $87 thousand and $26 thousand, respectively. The Company accounted for these repurchases as dividends of $87 thousand and $26 thousand, respectively, to its indirect parent NMH Investment, LLC to fund these repurchases.

Business_Combinations

Business Combinations	6 Months Ended
	Mar. 31, 2014
Business Combinations [Abstract]	'
Business Combinations	'
	5. Business Combinations
	The operating results of the businesses acquired are included in the consolidated statements of operations from the date of acquisition. The Company accounted for the acquisitions under the purchase method of accounting and, as a result, the purchase price was allocated to the assets acquired and liabilities assumed based upon their respective fair values. The excess of the purchase price over the estimated fair value of net tangible assets was allocated to specifically identified intangible assets, with the residual being allocated to goodwill.
	During the six months ended March 31, 2014, the Company acquired four companies complementary to its business for a total cash consideration of $11.8 million.
	Show-Me Health Care. On November 29, 2013, the Company acquired the assets of Show-Me Health Care for $1.2 million. Show-Me Health Care is located in Missouri and provides community-based supportive living services to individuals with developmental disabilities. As a result of this acquisition, the Company recorded $0.3 million of goodwill in the Human Services segment, which is expected to be deductible for tax purposes. The Company acquired $0.9 million of intangible assets which included $0.7 million of agency contracts with a weighted average useful life of 12 years, $0.2 million of licenses and permits with a weighted average useful life of 10 years, and $14 thousand of non-compete/non-solicit agreement with a useful life of 5 years.
	Occazio, Inc. (“Occazio”). On January 2, 2014, the Company acquired the assets of Occazio for $5.5 million. Occazio is located in Indiana and provides residential, home care and home health care services to consumers with intellectual and/or developmental disabilities. As a result of this acquisition, the Company recorded $1.4 million of goodwill in the Human Services segment, which is expected to be deductible for tax purposes. The Company acquired $3.9 million of intangible assets which included $2.9 million of agency contracts with a weighted average useful life of 12 years, $0.7 million of licenses and permits with a weighted average useful life of 10 years, $0.2 million trade name with a useful life of 5 years, and $24 thousand of non-compete/non-solicit agreement with a useful life of 5 years. The remaining purchase price was allocated to tangible assets.
	Momentum Rehabilitation Services, Inc., D/B/A Ann Arbor Rehabilitation Centers (“Ann Arbor”). On February 7, 2014, the Company acquired the assets of Ann Arbor for $4.8 million. Ann Arbor is located in Michigan and provides comprehensive on and off-campus residential housing and personalized daily services to adults with traumatic brain injury. As a result of this acquisition, the Company recorded $1.0 million of goodwill in the Post-Acute Specialty Rehabilitation Services segment, which is expected to be deductible for tax purposes. The Company acquired $3.8 million of intangible assets which included $3.7 million of agency contracts with a weighted average useful life of 12 years, $0.1 million trade name with a useful life of 5 years, and $33 thousand of non-compete/non-solicit agreement with a useful life of 5 years.
	Rose View Group Home, LLC (“Rose View”). On December 3, 2013, the Company acquired the assets of Rose View for $0.2 million. Rose View is located in Ohio and provides group home and related services to individuals with developmental disabilities.
	The following table summarizes the recognized amounts of identifiable assets acquired assumed at the date of the acquisition:
	(in thousands)	Show-Me		Occazio		Ann Arbor		Rose View		Total
		Health Care
	Identifiable intangible assets	$	895	$	3,863	$	3,800	$	143	$	8,701
	Property and equipment		9		216		50		—		275
	Total identifiable net assets	$	904	$	4,079	$	3,850	$	143	$	8,976
	Goodwill	$	336	$	1,421	$	972	$	57	$	2,786

Goodwill_and_Intangible_Assets

Goodwill and Intangible Assets	6 Months Ended
	Mar. 31, 2014
Goodwill And Intangible Assets Disclosure [Abstract]	'
Goodwill and Intangible Assets	'
	6. Goodwill and Intangible Assets
	Goodwill
	The changes in goodwill for the six months ended March 31, 2014 are as follows:
		Human		Post -Acute		Total
		Services		Specialty
				Rehabilitation
				Services
		(in thousands)
	Balance as of September 30, 2013	$	169,622	$	66,001	$	235,623
	Goodwill acquired through acquisitions		1,814		972		2,786
	Balance as of March 31, 2014	$	171,436	$	66,973	$	238,409
	Intangible Assets
	Intangible assets consist of the following as of March 31, 2014:
	Description	Gross		Accumulated		Intangible
		Carrying		Amortization		Assets,
		Value				Net
	(in thousands)
	Agency contracts	$	471,854	$	211,134	$	260,720
	Non-compete/non-solicit		5,006		2,529		2,477
	Relationship with contracted caregivers		10,963		8,454		2,509
	Trade names		4,067		2,655		1,412
	Trade names (indefinite life)		42,400		—		42,400
	Licenses and permits		46,730		30,668		16,062
	Intellectual property		904		622		282
		$	581,924	$	256,062	$	325,862
	Intangible assets consist of the following as of September 30, 2013:
	Description	Gross		Accumulated		Intangible
		Carrying		Amortization		Assets,
		Value				Net
	(in thousands)
	Agency contracts	$	464,480	$	195,737	$	268,743
	Non-compete/non-solicit		4,929		2,058		2,871
	Relationship with contracted caregivers		10,963		7,905		3,058
	Trade names		3,787		2,431		1,356
	Trade names (indefinite life)		42,400		—		42,400
	Licenses and permits		45,760		28,343		17,417
	Intellectual property		904		558		346
		$	573,223	$	237,032	$	336,191
	Amortization expense for continuing operations was $9.6 million and $19.0 million for the three and six months ended March 31, 2014, as compared to $9.3 million and $18.7 million for the three and six months ended March 31, 2013, respectively. There was no amortization expense for discontinued operations for the three and six months ended March 31, 2014, as compared to $0.1 million and $0.2 million for the three and six months ended March 31, 2013.
	The estimated remaining amortization expense related to intangible assets with finite lives for the six months remaining in fiscal 2014 and each of the four succeeding years and thereafter is as follows:
	(in thousands)
	2014	$	18,623
	2015		36,168
	2016		34,266
	2017		30,069
	2018		29,139
	Thereafter		135,197
		$	283,462

Related_Party_Transactions

Related Party Transactions	6 Months Ended
	Mar. 31, 2014
Related Party Transactions [Abstract]	'
Related Party Transactions	'
	7. Related Party Transactions
	Management Agreement
	On February 9, 2011, the Company entered into an amended and restated management agreement with Vestar Capital Partners V, L.P. (“Vestar”) relating to certain advisory and consulting services for an annual management fee equal to the greater of (i) $850 thousand or (ii) an amount equal to 1.0% of the Company’s consolidated earnings before interest, taxes, depreciation, amortization and management fee for each fiscal year determined as set forth in the Company’s senior credit agreement.
	As part of the management agreement, the Company agreed to indemnify Vestar and its affiliates from and against all losses, claims, damages and liabilities arising out of the performance by Vestar of its services pursuant to the management agreement. The management agreement will terminate upon such time that Vestar and its partners and their respective affiliates hold, directly or indirectly in the aggregate, less than 20% of the voting power of the outstanding voting stock of the Company.
	This agreement provides for the payment of reasonable and customary fees to Vestar for services in connection with a sale of the Company, an initial public offering by or involving NMH Investment, LLC (“NMH Investment”) or any of its subsidiaries or any extraordinary acquisition by or involving NMH Investment or any of its subsidiaries; provided, that such fees shall only be paid with the consent of the directors of the Company who are not affiliated with or employed by Vestar. The Company recorded $0.4 million and $0.7 million of management fees and expenses for the three and six months ended March 31, 2014, as compared to $0.3 million and $0.7 million in March 31, 2013, respectively. The accrued liability related to the management agreement was $0.2 million and $0.5 million at March 31, 2014 and September 30, 2013, respectively.
	Lease Agreements
	The Company leases several offices, homes and other facilities from its employees, or from relatives of employees, primarily in the states of Minnesota, Florida, and California. These leases have various expiration dates extending out as far as January 2019. Related party lease expense was $0.3 million and $0.7 million for the three and six months ended March 31, 2014, as compared to $0.4 million and $0.8 million for the three and six months ended March 31, 2013, respectively.

Fair_Value_Measurements

Fair Value Measurements	6 Months Ended
	Mar. 31, 2014
Fair Value Disclosures [Abstract]	'
Fair Value Measurements	'
	8. Fair Value Measurements
	The Company measures and reports its financial assets and liabilities on the basis of fair value. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date.
	A three-level hierarchy for disclosure has been established to show the extent and level of judgment used to estimate fair value measurements, as follows:
	Level 1: Quoted market prices in active markets for identical assets or liabilities.
	Level 2: Significant other observable inputs (quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, or inputs other than quoted prices that are observable for the asset or liability).
	Level 3: Significant unobservable inputs for the asset or liability. These values are generally determined using pricing models which utilize management estimates of market participant assumptions.
	Valuation techniques for assets and liabilities measured using Level 3 inputs may include methodologies such as the market approach, the income approach or the cost approach, and may use unobservable inputs such as projections, estimates and management’s interpretation of current market data. These unobservable inputs are only utilized to the extent that observable inputs are not available or cost-effective to obtain.
	A description of the valuation methodologies used for instruments measured at fair value as well as the general classification of such instruments pursuant to the valuation hierarchy, is set forth below.
	Assets and liabilities recorded at fair value at March 31, 2014 consist of:
	(in thousands)	Total			Quoted		Significant Other			Significant
					Market Prices		Observable			Unobservable
					(Level 1)		Inputs			Inputs
							(Level 2)			(Level 3)
	Interest rate swap agreements	$	(1,627	)	$	—	$	(1,627	)	$	—
	Assets and liabilities recorded at fair value at September 30, 2013 consist of:
	(in thousands)	Total			Quoted		Significant Other			Significant
					Market Prices		Observable			Unobservable
					(Level 1)		Inputs			Inputs
							(Level 2)			(Level 3)
	Interest rate swap agreements	$	(3,165	)	$	—	$	(3,165	)	$	—
	Interest rate swap agreements. The fair value of the swap agreements was recorded in current liabilities (under Other accrued liabilities) in the Company’s consolidated balance sheets. The fair value of these agreements was determined based on pricing models and independent formulas using current assumptions that included swap terms, interest rates and forward LIBOR curves and the Company’s credit risk.
	At March 31, 2014 and September 30, 2013, the carrying values of cash, accounts receivable, accounts payable and variable rate debt approximated fair value. The carrying value and fair value of the Company’s fixed rate debt instruments are set forth below:
		March 31, 2014					September 30, 2013
	(in thousands)	Carrying			Fair		Carrying			Fair
		Amount			Value		Amount			Value
	Senior notes (issued February 9, 2011)	$	206,744		$	226,840	$	242,997		$	268,750
	The fair values were estimated using calculations based on quoted market prices when available and company –specific credit risk. If the Company’s long-term debt was measured at fair value, it would have been categorized as Level 2 in the fair value hierarchy.

Income_Taxes

Income Taxes	6 Months Ended
	Mar. 31, 2014
Income Tax Disclosure [Abstract]	'
Income Taxes	'
	9. Income Taxes
	The Company’s effective income tax rate for the interim periods was based on management’s estimate of the Company’s annual effective tax rate for the applicable year. For the three and six months ended March 31, 2014, the Company’s effective income tax rate was 33.4% and 31.5%, as compared to an effective tax rate of 38.5% and 33.3% for the three and six months ended March 31, 2013. These rates differ from the federal statutory income tax rate primarily due to nondeductible permanent differences such as meals and nondeductible compensation, and net operating losses not benefited.
	NMH Holdings, Inc. files a federal consolidated return and files various state income tax returns. The Company files various state income tax returns and, generally, is no longer subject to income tax examinations by the taxing authorities for years prior to September 30, 2010. The Company did not have a reserve for uncertain income tax positions at March 31, 2014 and September 30, 2013. The Company does not expect any significant changes to unrecognized tax benefits within the next twelve months. The Company’s policy is to recognize interest and penalties related to unrecognized tax benefits as charges to income tax expense.

Segment_Information

Segment Information	6 Months Ended
	Mar. 31, 2014
Segment Reporting [Abstract]	'
Segment Information	'
	10. Segment Information
	The Company has two reportable segments, Human Services and Post-Acute Specialty Rehabilitation Services (“SRS”).
	The Human Services segment delivers home and community-based human services to adults and children with intellectual and/or developmental disabilities and to youth with emotional, behavioral and/or medically complex challenges. Human Services is organized in a reporting structure composed of two operating segments which are aggregated into one reportable segment based on similarity of the economic characteristics and services provided.
	The SRS segment delivers health care and community-based health and human services to individuals who have suffered acquired brain and/or spinal injuries and other catastrophic injuries and illnesses. This segment is organized in a reporting structure composed of two operating segments which are aggregated based on similarity of economic characteristics and services provided.
	Activities classified as “Corporate” in the table below relate primarily to unallocated home office items.
	The Company generally evaluates the performance of its operating segments based on income (loss) from operations. The following is a financial summary by reportable operating segment for the periods indicated.
	For the three months ended March 31,	Human			Post-Acute			Corporate			Consolidated
		Services			Specialty
					Rehabilitation
					Services
		(in thousands)
	2014
	Net revenue	$	254,627		$	55,188		$	—		$	309,815
	Income (loss) from operations		24,564			3,602			(13,099	)		15,067
	Total assets		656,084			200,503			149,464			1,006,051
	Depreciation and amortization		11,346			4,650			609			16,605
	Purchases of property and equipment		3,335			4,228			772			8,335
	Income (loss) from continuing operations before income taxes		(184	)		(1,583	)		(15,531	)		(17,298	)
	2013
	Net revenue	$	244,086		$	51,485		$	—		$	295,571
	Income (loss) from operations		20,258			3,596			(13,182	)		10,672
	Depreciation and amortization		11,248			3,840			549			15,637
	Purchases of property and equipment		3,111			1,687			2,350			7,148
	Income (loss) from continuing operations before income taxes		4,134			327			(12,992	)		(8,531	)
	For the six months ended March 31,	Human			Post-Acute			Corporate			Consolidated
		Services			Specialty
					Rehabilitation
					Services
		(in thousands)
	2014
	Net revenue	$	506,617		$	110,680		$	—		$	617,297
	Income (loss) from operations		46,654			7,902			(26,405	)		28,151
	Total assets		656,084			200,503			149,464			1,006,051
	Depreciation and amortization		22,390			9,023			1,257			32,670
	Purchases of property and equipment		6,395			6,455			1,508			14,358
	Income (loss) from continuing operations before income taxes		5,709			(730	)		(28,664	)		(23,685	)
	2013
	Net revenue	$	486,512		$	102,695		$	—		$	589,207
	Income (loss) from operations		40,114			8,030			(29,722	)		18,422
	Depreciation and amortization		22,304			7,689			1,152			31,145
	Purchases of property and equipment		8,532			3,957			2,886			15,375
	Income (loss) from continuing operations before income taxes		7,417			1,412			(29,208	)		(20,379	)
	Revenue derived from contracts with state and local governmental payors in the state of Minnesota, the Company’s largest state, which is included in the Human Services segment, accounted for approximately 14% of the Company’s revenue for the three and six months ended March 31, 2014, as compared to 14% for the three and six months ended March 31, 2013.

Accruals_for_SelfInsurance

Accruals for Self-Insurance	6 Months Ended
	Mar. 31, 2014
Commitments And Contingencies Disclosure [Abstract]	'
Accruals for Self-Insurance	'
	11. Accruals for Self-Insurance
	The Company maintains insurance for professional and general liability, workers’ compensation liability, automobile liability and health insurance liabilities that includes self-insured retentions. The Company intends to maintain such coverage in the future and is of the opinion that its insurance coverage is adequate to cover potential losses on asserted claims. Employment practices liability is fully self-insured.
	The Company records expenses related to claims on an incurred basis, which includes estimates of fully developed losses for both reported and unreported claims. The accruals for the health, workers’ compensation, automobile, and professional and general liability programs are based on analyses performed by management and take into account reports by independent third parties. Accruals are periodically reevaluated and increased or decreased based on new information.
	For professional and general liability, from October 1, 2011 to September 30, 2013, the Company was self-insured for the first $4.0 million of each and every claim with no aggregate limit. Commencing October 1, 2013, the Company is self-insured for $4.0 million per claim and $28.0 million in the aggregate. In connection with the acquisition by Vestar on June 29, 2006 (the “Merger”), the Company purchased additional insurance for certain claims relating to pre-Merger periods subject to $1.0 million per claim and up to $2.0 million in aggregate retentions.
	For workers’ compensation, the Company has a $350 thousand per claim retention with statutory limits. Automobile liability has a $100 thousand per claim retention, with additional insurance coverage above the retention. The Company purchases specific stop loss insurance as protection against extraordinary claims liability for health insurance claims. Stop loss insurance covers claims that exceed $300 thousand on a per member basis.
	The Company reports its self-insurance liabilities on a gross basis without giving effect to insurance recoveries. Anticipated insurance recoveries are presented in Prepaid expenses and other current assets and Other assets on the Company’s consolidated balance sheets. Self-insured liabilities are presented in Accrued payroll and related costs, Other accrued liabilities and Other long-term liabilities on its consolidated balance sheets.

Other_Commitments_and_Continge

Other Commitments and Contingencies	6 Months Ended
	Mar. 31, 2014
Commitments And Contingencies Disclosure [Abstract]	'
Other Commitments and Contingencies	'
	12. Other Commitments and Contingencies
	The Company is in the health and human services business and, therefore, has been and continues to be subject to substantial claims alleging that the Company, its employees or its independently contracted host-home caregivers (“Mentors”) failed to provide proper care for a client. The Company is also subject to claims by its clients, its employees, its Mentors or community members against the Company for negligence, intentional misconduct or violation of applicable laws. Included in the Company’s recent claims are claims alleging personal injury, assault, abuse, wrongful death and other charges. Regulatory agencies may initiate administrative proceedings alleging that the Company’s programs, employees or agents violate statutes and regulations and seek to impose monetary penalties on the Company. The Company could be required to incur significant costs to respond to regulatory investigations or defend against civil lawsuits and, if the Company does not prevail, the Company could be required to pay substantial amounts of money in damages, settlement amounts or penalties arising from these legal proceedings.
	The Company is also subject to potential lawsuits under the False Claims Act and other federal and state whistleblower statutes designed to combat fraud and abuse in the health care industry. These lawsuits can involve significant monetary awards that may incentivize private plaintiffs to bring these suits. If the Company is found to have violated the False Claims Act, it could be excluded from participation in Medicaid and other federal healthcare programs. The Patient Protection and Affordable Care Act provides a mandate for more vigorous and widespread enforcement activity to combat fraud and abuse in the health care industry.
	The Company is also subject to employee-related claims under state and federal law, including claims for discrimination, wrongful discharge or retaliation; claims for wage and hour violations under the Fair Labor Standards Act or state wage and hour laws.
	Two subsidiaries are named defendants in an action currently pending in the Illinois Circuit Court, Cook County, Law Division. The action was brought September 10, 2009, on behalf of a minor with disabilities by her guardian ad litem and biological parents who seek damages for injuries suffered by the minor during a foster home placement coordinated by the Company. The plaintiffs assert several claims against the Company including negligence and willful and wanton misconduct. In late 2013, the plaintiffs were granted leave to file an amended complaint seeking relief for punitive damages against the Company. Although substantial insurance cover is available, in the event the case is not settled within policy limits and proceeds to trial (currently scheduled for October 2014) an unfavorable outcome could be material to the results of operations, financial condition and cash flows of the Company.
	The Company reserves for costs related to contingencies in accordance with aggregate estimates, or when a loss is not included in its estimates and the loss is probable and the amount is reasonably estimable. While the Company believes the provision for legal contingencies is adequate, the outcome of the legal proceedings is difficult to predict and the Company may settle legal claims or be subject to judgments for amounts that differ from the Company’s estimates.

Subsequent_Events

Subsequent Events	6 Months Ended
	Mar. 31, 2014
Subsequent Events [Abstract]	'
Subsequent Events	'
	13. Subsequent Events
	Acquisitions
	Subsequent to the three months ended March 31, 2014, the Company acquired Tender Loving Care Metro, LLC which is complementary to its Human Service business. Aggregate cash consideration for this acquisition was $3.0 million. The Company is in the process of completing the allocation of the purchase prices to the fair value of net assets acquired.

Recent_Accounting_Pronouncemen1

Recent Accounting Pronouncements (Policies)	6 Months Ended
	Mar. 31, 2014
Accounting Changes And Error Corrections [Abstract]	'
Technical Corrections and Improvements	'
	Technical Corrections and Improvements — In October 2012, the FASB issued Accounting Standards Update No. 2012-04, Technical Corrections and Improvements (“ASU 2012-04”). The amendments in this update cover a wide range of Topics in the Accounting Standards Codification. These amendments include technical corrections and improvements to the Accounting Standards Codification and conforming amendments related to fair value measurements. The amendments in this update were effective for the Company beginning the first quarter of the fiscal year ending September 30, 2014. This adoption did not have a material impact on the Company’s consolidated financial statements.
	Technical Corrections and Improvements Related to Glossary Terms – In March 2014, the FASB issued Accounting Standards Update No. 2014-06, Technical Corrections and Improvements Related to Glossary Terms (“ASU 2014-06”). The amendments in this Update relate to glossary terms and cover a wide range of Topics in the Codification. The amendments in this Update were effective for the Company beginning the second quarter of the fiscal year ending September 30, 2014. This adoption did not have a material impact on the Company’s consolidated financial statements.

LongTerm_Debt_Tables

Long-Term Debt (Tables)	6 Months Ended
	Mar. 31, 2014
Debt Disclosure [Abstract]	'
Long-Term Debt	'
	As of March 31, 2014 and September 31, 2013, the Company’s long-term debt consisted of the following:
	(in thousands)	March 31,			September 30,
		2014			2013
	Term loan principal and interest due in quarterly installments through January 31, 2021, subject to acceleration to November 15, 2017	$	600,000		$	—
	Prior term loan, principal and interest repaid on January 31, 2014		—			546,525
	Original issue discount on term loan, net of accumulated amortization		(1,432	)		(4,403	)
	Senior notes, due February 15, 2018; semi-annual cash interest payments due each February 15th and August 15th (interest rate of 12.50%)		212,000			250,000
	Original issue discount and initial purchase discount on senior notes, net of accumulated amortization		(5,256	)		(7,003	)
			805,312			785,119
	Less current portion		6,000			5,600
	Long-term debt	$	799,312		$	779,519

Business_Combinations_Tables

Business Combinations (Tables)	6 Months Ended
	Mar. 31, 2014
Business Combinations [Abstract]	'
Schedule of Recognized Amounts of Identifiable Assets Acquired	'
	The following table summarizes the recognized amounts of identifiable assets acquired assumed at the date of the acquisition:
	(in thousands)	Show-Me		Occazio		Ann Arbor		Rose View		Total
		Health Care
	Identifiable intangible assets	$	895	$	3,863	$	3,800	$	143	$	8,701
	Property and equipment		9		216		50		—		275
	Total identifiable net assets	$	904	$	4,079	$	3,850	$	143	$	8,976
	Goodwill	$	336	$	1,421	$	972	$	57	$	2,786

Goodwill_and_Intangible_Assets1

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Mar. 31, 2014
Goodwill And Intangible Assets Disclosure [Abstract]	'
Schedule of Changes in Goodwill	'
	The changes in goodwill for the six months ended March 31, 2014 are as follows:
		Human		Post -Acute		Total
		Services		Specialty
				Rehabilitation
				Services
		(in thousands)
	Balance as of September 30, 2013	$	169,622	$	66,001	$	235,623
	Goodwill acquired through acquisitions		1,814		972		2,786
	Balance as of March 31, 2014	$	171,436	$	66,973	$	238,409
Schedule of Intangible Assets	'
	Intangible assets consist of the following as of March 31, 2014:
	Description	Gross		Accumulated		Intangible
		Carrying		Amortization		Assets,
		Value				Net
	(in thousands)
	Agency contracts	$	471,854	$	211,134	$	260,720
	Non-compete/non-solicit		5,006		2,529		2,477
	Relationship with contracted caregivers		10,963		8,454		2,509
	Trade names		4,067		2,655		1,412
	Trade names (indefinite life)		42,400		—		42,400
	Licenses and permits		46,730		30,668		16,062
	Intellectual property		904		622		282
		$	581,924	$	256,062	$	325,862
	Intangible assets consist of the following as of September 30, 2013:
	Description	Gross		Accumulated		Intangible
		Carrying		Amortization		Assets,
		Value				Net
	(in thousands)
	Agency contracts	$	464,480	$	195,737	$	268,743
	Non-compete/non-solicit		4,929		2,058		2,871
	Relationship with contracted caregivers		10,963		7,905		3,058
	Trade names		3,787		2,431		1,356
	Trade names (indefinite life)		42,400		—		42,400
	Licenses and permits		45,760		28,343		17,417
	Intellectual property		904		558		346
		$	573,223	$	237,032	$	336,191
Schedule of Amortization Expense Related to Intangible Assets	'
	The estimated remaining amortization expense related to intangible assets with finite lives for the six months remaining in fiscal 2014 and each of the four succeeding years and thereafter is as follows:
	(in thousands)
	2014	$	18,623
	2015		36,168
	2016		34,266
	2017		30,069
	2018		29,139
	Thereafter		135,197
		$	283,462

Fair_Value_Measurements_Tables

Fair Value Measurements (Tables)	6 Months Ended
	Mar. 31, 2014
Fair Value Disclosures [Abstract]	'
Fair Value of Assets and Liabilities	'
	Assets and liabilities recorded at fair value at March 31, 2014 consist of:
	(in thousands)	Total			Quoted		Significant Other			Significant
					Market Prices		Observable			Unobservable
					(Level 1)		Inputs			Inputs
							(Level 2)			(Level 3)
	Interest rate swap agreements	$	(1,627	)	$	—	$	(1,627	)	$	—
	Assets and liabilities recorded at fair value at September 30, 2013 consist of:
	(in thousands)	Total			Quoted		Significant Other			Significant
					Market Prices		Observable			Unobservable
					(Level 1)		Inputs			Inputs
							(Level 2)			(Level 3)
	Interest rate swap agreements	$	(3,165	)	$	—	$	(3,165	)	$	—
Carrying Amount of Debt Instrument	'
	At March 31, 2014 and September 30, 2013, the carrying values of cash, accounts receivable, accounts payable and variable rate debt approximated fair value. The carrying value and fair value of the Company’s fixed rate debt instruments are set forth below:
		March 31, 2014					September 30, 2013
	(in thousands)	Carrying			Fair		Carrying			Fair
		Amount			Value		Amount			Value
	Senior notes (issued February 9, 2011)	$	206,744		$	226,840	$	242,997		$	268,750

Segment_Information_Tables

Segment Information (Tables)	6 Months Ended
	Mar. 31, 2014
Segment Reporting [Abstract]	'
Performance of Operating Segments	'
	The Company generally evaluates the performance of its operating segments based on income (loss) from operations. The following is a financial summary by reportable operating segment for the periods indicated.
	For the three months ended March 31,	Human			Post-Acute			Corporate			Consolidated
		Services			Specialty
					Rehabilitation
					Services
		(in thousands)
	2014
	Net revenue	$	254,627		$	55,188		$	—		$	309,815
	Income (loss) from operations		24,564			3,602			(13,099	)		15,067
	Total assets		656,084			200,503			149,464			1,006,051
	Depreciation and amortization		11,346			4,650			609			16,605
	Purchases of property and equipment		3,335			4,228			772			8,335
	Income (loss) from continuing operations before income taxes		(184	)		(1,583	)		(15,531	)		(17,298	)
	2013
	Net revenue	$	244,086		$	51,485		$	—		$	295,571
	Income (loss) from operations		20,258			3,596			(13,182	)		10,672
	Depreciation and amortization		11,248			3,840			549			15,637
	Purchases of property and equipment		3,111			1,687			2,350			7,148
	Income (loss) from continuing operations before income taxes		4,134			327			(12,992	)		(8,531	)
	For the six months ended March 31,	Human			Post-Acute			Corporate			Consolidated
		Services			Specialty
					Rehabilitation
					Services
		(in thousands)
	2014
	Net revenue	$	506,617		$	110,680		$	—		$	617,297
	Income (loss) from operations		46,654			7,902			(26,405	)		28,151
	Total assets		656,084			200,503			149,464			1,006,051
	Depreciation and amortization		22,390			9,023			1,257			32,670
	Purchases of property and equipment		6,395			6,455			1,508			14,358
	Income (loss) from continuing operations before income taxes		5,709			(730	)		(28,664	)		(23,685	)
	2013
	Net revenue	$	486,512		$	102,695		$	—		$	589,207
	Income (loss) from operations		40,114			8,030			(29,722	)		18,422
	Depreciation and amortization		22,304			7,689			1,152			31,145
	Purchases of property and equipment		8,532			3,957			2,886			15,375
	Income (loss) from continuing operations before income taxes		7,417			1,412			(29,208	)		(20,379	)

Basis_of_Presentation_Addition

Basis of Presentation - Additional Information (Detail)	Mar. 31, 2014
	Clients
	State
Organization Consolidation And Presentation Of Financial Statements [Abstract]	'
Area of operations, number of states	36
Number of residential clients	12,500
Number of periodic clients	16,100

LongTerm_Debt_LongTerm_Debt_De

Long-Term Debt - Long-Term Debt (Detail) (USD $)	Mar. 31, 2014	Sep. 30, 2013
In Thousands, unless otherwise specified
Debt Instrument [Line Items]	'	'
Long-term debt	$805,312	$785,119
Less current portion	6,000	5,600
Long-term debt	799,312	779,519
Term Loan Principal and Interest Due in Quarterly Installments Through January 31, 2021 [Member]	'	'
Debt Instrument [Line Items]	'	'
Long-term debt	600,000	'
Prior Term Loan, Principal and Interest Repaid on January 31, 2014, Subject to Acceleration to November 15, 2017 [Member]	'	'
Debt Instrument [Line Items]	'	'
Long-term debt	'	546,525
Original Issue Discount on Term Loan, Net of Accumulated Amortization [Member]	'	'
Debt Instrument [Line Items]	'	'
Long-term debt	-1,432	-4,403
Senior Notes [Member]	'	'
Debt Instrument [Line Items]	'	'
Long-term debt	212,000	250,000
Original Issue Discount and Initial Purchase Discount on Senior Notes, Net of Accumulated Amortization [Member]	'	'
Debt Instrument [Line Items]	'	'
Long-term debt	($5,256)	($7,003)

LongTerm_Debt_LongTerm_Debt_Pa

Long-Term Debt - Long-Term Debt (Parenthetical) (Detail)	6 Months Ended	12 Months Ended
	Mar. 31, 2014	Sep. 30, 2013	Feb. 28, 2011
Senior Notes [Member]	'	'	'
Debt Instrument [Line Items]	'	'	'
Debt instrument, maturity date	15-Feb-18	15-Feb-18	'
Debt instrument, interest rate	12.50%	12.50%	12.50%
Term Loan [Member]	'	'	'
Debt Instrument [Line Items]	'	'	'
Debt instrument, maturity date	31-Jan-21	31-Jan-21	'

LongTerm_Debt_Additional_Infor

Long-Term Debt - Additional Information (Detail) (USD $)

0 Months Ended

3 Months Ended

6 Months Ended

6 Months Ended

6 Months Ended

0 Months Ended

6 Months Ended

0 Months Ended

6 Months Ended

1 Months Ended

6 Months Ended

12 Months Ended

6 Months Ended

12 Months Ended

6 Months Ended

3 Months Ended

6 Months Ended

6 Months Ended

Feb. 26, 2014

Oct. 15, 2012

Mar. 31, 2014

Mar. 31, 2014

Sep. 30, 2013

Mar. 31, 2014

Oct. 15, 2012

Mar. 31, 2011

Mar. 31, 2014

Jan. 31, 2014

Mar. 31, 2014

Mar. 31, 2014

Feb. 26, 2014

Mar. 31, 2014

Mar. 31, 2014

Sep. 30, 2013

Feb. 28, 2011

Mar. 31, 2014

Sep. 30, 2013

Mar. 31, 2014

Sep. 30, 2013

Sep. 30, 2011

Jan. 31, 2014

Sep. 30, 2011

Sep. 30, 2011

Mar. 31, 2014

Jan. 31, 2014

Mar. 31, 2014

Oct. 15, 2012

Mar. 31, 2014

Mar. 31, 2014

Jan. 31, 2014

Mar. 31, 2014

Mar. 31, 2014

Mar. 31, 2014

Mar. 31, 2014

Mar. 31, 2014

Derivatives [Member]

Derivatives [Member]

Interest Rate Swap [Member]

Interest Rate Swap Agreements [Member]

Secured Debt [Member]

Senior Secured Credit Facility [Member]

Revolving Credit Facility [Member]

Partial Redemption [Member]

Prior Term Loan and Incremental Term Loan Facilities [Member]

Senior Notes [Member]

Senior Notes [Member]

Senior Notes [Member]

Term Loan [Member]

Term Loan [Member]

Term Loan [Member]

Term Loan [Member]

Term Loan [Member]

Term Loan [Member]

Senior Revolver [Member]

Senior Revolver [Member]

Covenants [Member]

Prior Term Loan [Member]

Prior Senior Revolver [Member]

Letters of Credit [Member]

Letters of Credit [Member]

Senior Secured Credit Facilities [Member]

Swingline and The Senior Revolver [Member]

Interest Rate Swap [Member]

Eurodollar Future [Member]

Standby Letters of Credit [Member]

Derivatives [Member]

Secured Debt [Member]

Minimum [Member]

Maximum [Member]

Derivatives [Member]

Senior Revolver [Member]

Maximum [Member]

Short Term And Long Term Debt [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Amount of indebtedness

'

'

'

'

$785,100,000

'

'

'

'

'

'

'

'

'

'

$546,500,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt unamortized original issue discount

'

'

'

'

4,400,000

'

'

'

'

'

'

'

'

'

'

'

5,600,000

'

7,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt instrument, face amount

'

'

805,312,000

805,312,000

785,119,000

'

'

'

'

'

'

'

'

'

'

'

'

212,000,000

250,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt instrument, interest rate

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

12.50%

12.50%

12.50%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Borrowing under old senior revolving credit facility

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

0

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt expenses

'

'

600,000

600,000

'

'

'

'

'

11,100,000

'

'

3,600,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Deferred financing costs

'

'

'

'

'

'

'

'

'

7,200,000

'

'

200,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Write-off of original issue discount related to prior indebtedness

'

'

'

'

'

'

'

'

'

3,900,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Redemption of debt, principal amount

38,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Expense of redemption premium

'

'

'

'

'

'

'

'

'

'

'

'

2,400,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt original issue discount

'

'

'

'

'

'

'

'

'

'

'

'

1,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt instrument, face amount

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

250,000,000

'

'

'

'

'

600,000,000

'

'

'

100,000,000

'

'

'

'

'

'

'

'

'

'

Amount deposited in cash collateral account in support of issuance of letters of credit

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

50,000,000

'

'

'

'

'

Debt instrument maturity term

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'7 years

'

'

'

'

'

'

'

'

'

'

'

'

'5 years

'1 year

'

'

'

Long-term Debt, Description

'

'

'

'

'

'

'

'

'

'

'The term loan facility has a seven-year maturity and the senior revolver has a five-year maturity; provided, that if the Company's senior notes due 2018 are not refinanced in full on or prior to the date that is three months prior to February 15, 2018, such maturity dates shall spring forward to November 15, 2017.

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Percentage of capital stock of certain domestic subsidiaries owned by company and other domestic subsidiary guarantor

'

'

'

100.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Variable interest rate on senior secured credit facilities

'

'

'

'

'

'

'

'

'

'

'Borrowings under the senior secured credit facilities bear interest, at the Companybs option, at: (i) an ABR rate equal to the greater of (a) the prime rate of Barclays Bank PLC, (b) the federal funds rate plus 1/2 of 1.0%, and (c) the Eurodollar rate for an interest period of one-month beginning on such day plus 100 basis points, plus 2.75% (provided that the ABR rate applicable to the term loan facility will not be less than 2.00% per annum); or (ii) the Eurodollar rate (provided that the Eurodollar rate applicable to the term loan facility will not be less than 1.00% per annum), plus 3.75%. The Company is also required to pay a commitment fee to the lenders under the senior revolver at an initial rate of 0.50% of the average daily unutilized commitments thereunder. The Company must also pay customary letter of credit fees, including a fronting fee as well as administration fees.

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Revolver basis spread on variable rate, federal funds

'

'

'

1.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

2.75%

3.75%

'

Line of credit, floor rate

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

2.00%

1.00%

'

Eurodollar rate for interest period

'

'

'

1.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt instrument initial rate of commitments

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

0.50%

'

'

'

'

'

'

'

'

'

'

'

Percentage of annual excess cash flow

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

50.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Percentage of net cash proceeds of non-ordinary course assets sales or other dispositions of property

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

100.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Net cash proceeds of debt incurrence

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

100.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Repayment of principal installment

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

0.25%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Percentage of loans prepaid or repriced

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

1.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Price of prior term loan issued of its face value

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

98.50%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Provision for prepayment of outstanding term loan

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'0 to 50%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Prepayment term loan percentage

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

0.00%

50.00%

'

'

'

'

'

'

'

'

'

'

'

'

Borrowings under the term loan

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

600,000,000

'

'

'

'

'

'

'

'

'

'

50,000,000

'

'

'

'

'

'

Interest rate on term loan

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

4.75%

'

'

'

'

'

'

'

'

7.30%

'

'

'

'

'

'

'

'

Drawings

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

9,300,000

'

'

'

'

'

'

'

'

'

'

'

Repayment

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

9,300,000

'

'

'

'

'

'

'

'

'

'

'

Availability of borrowings

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

100,000,000

'

'

'

'

'

'

'

'

'

'

'

Outstanding borrowings

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

44,700,000

Outstanding Amount

'

'

'

'

'

'

'

'

'

'

'

0

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Interest rate for borrowings

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

6.00%

'

'

'

'

'

'

Debt instrument, maximum borrowing capacity

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

75,000,000

'

'

'

'

'

'

'

Rate of price of face value

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

97.70%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Net proceeds

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

244,300,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Aggregate principal amount redeemed

38,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Redemption price percentage of principal amount redeemed

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

106.25%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Agreement contains a springing financial covenant

'

'

'

'The senior credit agreement contains a springing financial covenant that requires the Company to maintain a specified consolidated leverage ratio in the event the Company borrows in excess of 30% of its senior revolver commitment if, at the end of any fiscal quarter our usage of the senior revolver exceeds 30% of the commitments thereunder, we are required to maintain at the end of each such fiscal quarter, commencing with the quarter ending June 30, 2014, a consolidated first lien leverage ratio of not more than 5.50 to 1.00. This consolidated first lien leverage ratio will step down to 5.00 to 1.00 commencing with the fiscal quarter ending March 31, 2017.

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Percentage of senior revolving commitment

'

'

'

30.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Percentage of revolving commitments

'

'

'

30.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Consolidated first lien leverage ratio, maximum

'

'

'

'

'

'

'

'

'

'

'

'

'

5.5

5

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Maximum limit of dividends pay to NMH Holdings, LLC ("Parent")

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

15,000,000

'

'

'

'

'

'

'

'

'

Interest rate swap in a notional amount

'

'

'

'

'

'

'

400,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Maturity date of derivative instrument

'

'

'

'

'

30-Sep-14

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Quarterly payment received from counter party

'

'Equal to the greater of 3-month LIBOR and 1.25% per annum

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Payments on fixed rate

'

2.08%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Fair value of the interest rate swap

'

68,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Applicable margin rate on Company's old term loan

'

'

'

'

'

'

5.25%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Margin on base rate (as a percent) for interest rate swap

'

1.25%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt instrument maturity date

'

'

'

'

'

'

'

'

30-Sep-14

'

'

'

'

'

'

'

'

15-Feb-18

15-Feb-18

31-Jan-21

31-Jan-21

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Unamortized historical mark to market adjustments amount

'

'

'

1,100,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Unamortized historical mark to market adjustments tax amount

'

'

'

$700,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Shareholders_Equity_Additional

Shareholder's Equity - Additional Information (Detail) (USD $)	6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Equity [Abstract]	'	'
Common stock vote per share	'One vote per share	'
Repurchase equity accounted as dividends	$87	$26
Repurchase of equity shares from employees- NMH Investment	$87	$26

Business_Combinations_Addition

Business Combinations - Additional Information (Detail) (USD $)

6 Months Ended

0 Months Ended

0 Months Ended

0 Months Ended

0 Months Ended

Mar. 31, 2014

Feb. 07, 2014

Mar. 31, 2014

Feb. 07, 2014

Feb. 07, 2014

Feb. 07, 2014

Jan. 02, 2014

Mar. 31, 2014

Jan. 02, 2014

Jan. 02, 2014

Jan. 02, 2014

Jan. 02, 2014

Nov. 29, 2013

Mar. 31, 2014

Nov. 29, 2013

Nov. 29, 2013

Nov. 29, 2013

Dec. 03, 2013

Mar. 31, 2014

Company

Ann Arbor [Member]

Ann Arbor [Member]

Ann Arbor [Member]

Ann Arbor [Member]

Ann Arbor [Member]

Occazio [Member]

Occazio [Member]

Occazio [Member]

Occazio [Member]

Occazio [Member]

Occazio [Member]

Show Me Health Care [Member]

Show Me Health Care [Member]

Show Me Health Care [Member]

Show Me Health Care [Member]

Show Me Health Care [Member]

Rose View [Member]

Rose View [Member]

Trade Names [Member]

Agency Contracts [Member]

Non-Compete Agreements [Member]

Trade Names [Member]

Agency Contracts [Member]

Non-Compete Agreements [Member]

Licenses and Permits [Member]

Agency Contracts [Member]

Non-Compete Agreements [Member]

Licenses and Permits [Member]

Business Acquisition [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Number of companies acquired

4

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Fair value consideration of acquired companies

$11,800,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Cost of acquisition

'

4,800,000

'

'

'

'

5,500,000

'

'

'

'

'

1,200,000

'

'

'

'

200,000

'

Fair value of goodwill

2,786,000

1,000,000

972,000

'

'

'

1,400,000

1,421,000

'

'

'

'

300,000

336,000

'

'

'

'

57,000

Recognized identifiable intangible assets acquired

'

$3,800,000

'

$100,000

$3,700,000

$33,000

$3,900,000

'

$200,000

$2,900,000

$24,000

$700,000

$900,000

'

$700,000

$14,000

$200,000

'

'

Tenure of agency contract

'

'

'

'5 years

'12 years

'5 years

'

'

'5 years

'12 years

'5 years

'10 years

'

'

'12 years

'5 years

'10 years

'

'

Business_Combinations_Schedule

Business Combinations - Schedule of Recognized Amounts of Identifiable Assets Acquired (Detail) (USD $)	Mar. 31, 2014	Mar. 31, 2014	Nov. 29, 2013	Mar. 31, 2014	Jan. 02, 2014	Mar. 31, 2014	Feb. 07, 2014	Mar. 31, 2014
In Thousands, unless otherwise specified		Show Me Health Care [Member]	Show Me Health Care [Member]	Occazio [Member]	Occazio [Member]	Ann Arbor [Member]	Ann Arbor [Member]	Rose View [Member]
Business Acquisition [Line Items]	'	'	'	'	'	'	'	'
Identifiable intangible assets	$8,701	$895	'	$3,863	'	$3,800	'	$143
Property and equipment	275	9	'	216	'	50	'	'
Total identifiable net assets	8,976	904	'	4,079	'	3,850	'	143
Goodwill	$2,786	$336	$300	$1,421	$1,400	$972	$1,000	$57

Goodwill_and_Intangible_Assets2

Goodwill and Intangible Assets - Schedule of Changes in Goodwill (Detail) (USD $)	6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014
Goodwill [Line Items]	'
Beginning Balance	$235,623
Goodwill acquired through acquisitions	2,786
Ending Balance	238,409
Human Services [Member]	'
Goodwill [Line Items]	'
Beginning Balance	169,622
Goodwill acquired through acquisitions	1,814
Ending Balance	171,436
Post-Acute Specialty Rehabilitation Services [Member]	'
Goodwill [Line Items]	'
Beginning Balance	66,001
Goodwill acquired through acquisitions	972
Ending Balance	$66,973

Goodwill_and_Intangible_Assets3

Goodwill and Intangible Assets - Schedule of Intangible Assets (Detail) (USD $)	Mar. 31, 2014	Sep. 30, 2013
In Thousands, unless otherwise specified
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	$581,924	$573,223
Accumulated Amortization	256,062	237,032
Intangible Assets, Net	325,862	336,191
Agency Contracts [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	471,854	464,480
Accumulated Amortization	211,134	195,737
Intangible Assets, Net	260,720	268,743
Non-Compete/Non-Solicit [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	5,006	4,929
Accumulated Amortization	2,529	2,058
Intangible Assets, Net	2,477	2,871
Relationship with Contracted Caregivers [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	10,963	10,963
Accumulated Amortization	8,454	7,905
Intangible Assets, Net	2,509	3,058
Trade Names (Indefinite Life) [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	42,400	42,400
Accumulated Amortization	'	'
Intangible Assets, Net	42,400	42,400
Licenses and Permits [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	46,730	45,760
Accumulated Amortization	30,668	28,343
Intangible Assets, Net	16,062	17,417
Intellectual Property [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	904	904
Accumulated Amortization	622	558
Intangible Assets, Net	282	346
Trade Names [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Value	4,067	3,787
Accumulated Amortization	2,655	2,431
Intangible Assets, Net	$1,412	$1,356

Goodwill_and_Intangible_Assets4

Goodwill and Intangible Assets - Additional Information (Detail) (Finite-Lived Intangible Assets [Member], USD $)	3 Months Ended		6 Months Ended
In Millions, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013
Finite-Lived Intangible Assets [Member]	'	'	'	'
Goodwill And Intangible Assets Disclosure [Line Items]	'	'	'	'
Amortization expense for continuing operations	$9.60	$9.30	$19	$18.70
Amortization expense for discontinued operations	$0	$0.10	$0	$0.20

Goodwill_and_Intangible_Assets5

Goodwill and Intangible Assets - Schedule of Amortization Expense Related to Intangible Assets (Detail) (USD $)	Mar. 31, 2014
In Thousands, unless otherwise specified
Goodwill And Intangible Assets Disclosure [Abstract]	'
2014	$18,623
2015	36,168
2016	34,266
2017	30,069
2018	29,139
Thereafter	135,197
Amortization expense related to intangible assets	$283,462

Related_Party_Transactions_Add

Related Party Transactions - Additional Information (Detail) (USD $)	0 Months Ended	3 Months Ended		6 Months Ended
	Feb. 09, 2011	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013	Sep. 30, 2013
Related Party Transaction [Line Items]	'	'	'	'	'	'
Contract termination, percentage of voting power of outstanding voting stock	'	20.00%	'	'	'	'
Management fees and expenses	'	$354,000	$329,000	$699,000	$665,000	'
Vestar Capital Partners [Member]	'	'	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'	'	'
Management fee percentage of consolidated earnings before interest, taxes, depreciation, amortization and management fee	1.00%	'	'	'	'	'
Management fees and expenses	'	400,000	300,000	700,000	700,000	'
Accrued liability related to management agreement	'	200,000	'	200,000	'	500,000
Vestar Capital Partners [Member] | Minimum [Member]	'	'	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'	'	'
Annual management fee for certain advisory and consulting services payable	850,000	'	'	'	'	'
Lease Agreements [Member]	'	'	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'	'	'
Related party lease expense	'	$300,000	$400,000	$700,000	$800,000	'
Lease Agreements [Member] | Maximum [Member]	'	'	'	'	'	'
Related Party Transaction [Line Items]	'	'	'	'	'	'
Lease expiration date	'	'	'	31-Jan-19	'	'

Fair_Value_Measurements_Fair_V

Fair Value Measurements - Fair Value of Assets and Liabilities (Detail) (Interest Rate Swap Agreements [Member], USD $)	Mar. 31, 2014	Sep. 30, 2013
In Thousands, unless otherwise specified
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Fair value of assets and liabilities	($1,627)	($3,165)
Quoted Market Prices (Level 1) [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Fair value of assets and liabilities	'	'
Significant Other Observable Inputs (Level 2) [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Fair value of assets and liabilities	-1,627	-3,165
Significant Unobservable Inputs (Level 3) [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Fair value of assets and liabilities	'	'

Fair_Value_Measurements_Carryi

Fair Value Measurements - Carrying Amount of Debt Instrument (Detail) (USD $)	Mar. 31, 2014	Sep. 30, 2013
In Thousands, unless otherwise specified
Carrying Amount [Member]	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Senior notes (issued February 9, 2011)	$206,744	$242,997
Fair Value [Member]	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Senior notes (issued February 9, 2011)	$226,840	$268,750

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013	Sep. 30, 2013
Income Tax Disclosure [Abstract]	'	'	'	'	'
Effective tax rate	33.40%	38.50%	31.50%	33.30%	'
Reserve for uncertain income tax positions	$0	'	$0	'	$0

Segment_Information_Additional

Segment Information - Additional Information (Detail)	3 Months Ended		6 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013
Segment Reporting Information [Line Items]	'	'	'	'
Number of reportable segments	'	'	2	'
Human Services [Member]	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'
Number of operating segments	'	'	2	'
Human Services [Member] | State and Local Government Payor [Member] | Sales [Member]	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'
Revenue derived from contracts with state and local governmental payors in the state of Minnesota	14.00%	14.00%	14.00%	14.00%
Post-Acute Specialty Rehabilitation Services [Member]	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'
Number of operating segments	'	'	2	'

Segment_Information_Performanc

Segment Information - Performance of Operating Segments (Detail) (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014	Mar. 31, 2013	Sep. 30, 2013
Segment Reporting Information [Line Items]	'	'	'	'	'
Net revenue	$309,815	$295,571	$617,297	$589,207	'
Income (loss) from operations	15,067	10,672	28,151	18,422	'
Total assets	1,006,051	'	1,006,051	'	1,020,372
Depreciation and amortization	16,605	15,637	32,670	31,145	'
Purchases of property and equipment	8,335	7,148	14,358	15,375	'
Income (loss) from continuing operations before income taxes	-17,298	-8,531	-23,685	-20,379	'
Human Services [Member]	'	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'	'
Net revenue	254,627	244,086	506,617	486,512	'
Income (loss) from operations	24,564	20,258	46,654	40,114	'
Total assets	656,084	'	656,084	'	'
Depreciation and amortization	11,346	11,248	22,390	22,304	'
Purchases of property and equipment	3,335	3,111	6,395	8,532	'
Income (loss) from continuing operations before income taxes	-184	4,134	5,709	7,417	'
Post-Acute Specialty Rehabilitation Services [Member]	'	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'	'
Net revenue	55,188	51,485	110,680	102,695	'
Income (loss) from operations	3,602	3,596	7,902	8,030	'
Total assets	200,503	'	200,503	'	'
Depreciation and amortization	4,650	3,840	9,023	7,689	'
Purchases of property and equipment	4,228	1,687	6,455	3,957	'
Income (loss) from continuing operations before income taxes	-1,583	327	-730	1,412	'
Corporate [Member]	'	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'	'
Net revenue	'	'	'	'	'
Income (loss) from operations	-13,099	-13,182	-26,405	-29,722	'
Total assets	149,464	'	149,464	'	'
Depreciation and amortization	609	549	1,257	1,152	'
Purchases of property and equipment	772	2,350	1,508	2,886	'
Income (loss) from continuing operations before income taxes	($15,531)	($12,992)	($28,664)	($29,208)	'

Accruals_for_SelfInsurance_Add

Accruals for Self-Insurance - Additional Information (Detail) (USD $)	0 Months Ended		6 Months Ended	24 Months Ended
	Oct. 02, 2013	Jun. 29, 2006	Mar. 31, 2014	Sep. 30, 2013
Commitments And Contingencies Disclosure [Abstract]	'	'	'	'
Aggregate self-insurance for professional and general liability	$28,000,000	$2,000,000	'	$0
Insured amount for professional and general liability, per claim	4,000,000	1,000,000	'	4,000,000
Claim retention with statutory limit, Workers' compensation	'	'	350,000	'
Claim retention with statutory limit, automobile liability	'	'	100,000	'
Stop loss insurance coverage against extra ordinary claims	'	'	$300,000	'

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail) (USD $)	6 Months Ended	3 Months Ended
In Millions, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2014
		Subsequent Events [Member]
Subsequent Event [Line Items]	'	'
Aggregate consideration for the acquisition	$11.80	$3