Segment Reporting (Details 3) (USD $) In Thousands, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Segment Reporting Information Profit Loss
Revenues	$ 139,008	$ 132,592	$ 112,221	$ 106,030	$ 160,841	$ 65,284	$ 62,405	$ 63,831	$ 489,851	$ 352,361	$ 309,711
Operating expenses	(105,076)	(91,625)	(80,811)	(75,194)	(108,938)	(82,133)	(55,422)	(52,998)	(352,706)	(299,491)	(186,908)
Interest expense									(103,728)	(46,448)	(18,210)
Other, net									52,472	87,921	85,632
Provision for income taxes									(1,252)	(6,772)	(37,214)
Income from continuing operations before income taxes									84,637	87,571	153,011
Assets
Assets	4,678,950				4,609,042				4,678,950	4,609,042
Long-lived assets	3,333,654				3,239,755				3,333,654	3,239,755
Real Estate Investments
Segment Reporting Information Profit Loss
Revenues									315,965	129,181	67,064
Operating expenses									(178,962)	(92,441)	(29,336)
Interest expense									(103,728)	(46,448)	(18,210)
Other, net									51,704	84,043	82,937
Provision for income taxes									(4,703)	(4,001)	(2,243)
Income from continuing operations before income taxes									80,276	70,334	100,212
Assets
Assets	4,537,853				4,484,821				4,537,853	4,484,821	1,334,066
Long-lived assets	3,333,654				3,239,755				3,333,654	3,239,755	1,273,521
Domestic | Real Estate Investments
Segment Reporting Information Profit Loss
Revenues									218,758	100,619	58,940
Operating expenses									(126,534)	(91,196)	(25,821)
Interest expense									(65,978)	(35,239)	(16,884)
Other, net									48,405	77,441	76,764
Provision for income taxes									19	(2,690)	(2,135)
Income from continuing operations before income taxes									74,670	48,935	90,864
Assets
Assets	3,290,568				3,527,918				3,290,568	3,527,918	1,258,544
Long-lived assets	2,172,549				2,552,481				2,172,549	2,552,481	1,207,435
International | Real Estate Investments
Segment Reporting Information Profit Loss
Revenues									97,207	28,562	8,124
Operating expenses									(52,428)	(1,245)	(3,515)
Interest expense									(37,750)	(11,209)	(1,326)
Other, net									3,299	6,602	6,173
Provision for income taxes									(4,722)	(1,311)	(108)
Income from continuing operations before income taxes									5,606	21,399	9,348
Assets
Assets	1,247,285				956,903				1,247,285	956,903	75,522
Long-lived assets	1,161,105				687,274				1,161,105	687,274	66,086
Medica France, S.A. | International | Real Estate Investments
Segment Reporting Information Profit Loss
Other, net										$ 15,100