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Investments (Narrative) (Details)
£ in Millions
1 Months Ended 3 Months Ended 9 Months Ended
Sep. 30, 2017
USD ($)
Sep. 30, 2017
USD ($)
Sep. 30, 2017
USD ($)
Sep. 30, 2016
USD ($)
Sep. 30, 2017
GBP (£)
Dec. 31, 2016
USD ($)
Dec. 31, 2016
GBP (£)
Schedule of Investments [Line Items]              
Commercial paper and money market investments $ 205,800,000 $ 205,800,000 $ 205,800,000     $ 485,100,000  
Marketable equity securities $ 495,599,000 495,599,000 495,599,000     $ 424,229,000  
Marketable equity securities purchased     0 $ 47,900,000      
Cash paid for new marketable equity securities     0 48,265,000      
Proceeds from sales of marketable equity securities     0 22,800,000      
Gain on sales of marketable equity securities       $ 6,300,000      
Celtic and Residential [Member]              
Schedule of Investments [Line Items]              
Revenue from Related Parties   $ 4,500,000 $ 14,100,000        
Intersection Holdings [Member]              
Schedule of Investments [Line Items]              
Equity Method Investment, Percentage Acquired 10.00%            
Residential Home Health Illinois [Member] | Residential Healthcare Group Inc [Member]              
Schedule of Investments [Line Items]              
Equity Method Investment, Ownership Percentage 40.00% 40.00% 40.00%   40.00%    
Residential Hospice Illinois [Member] | Residential Healthcare Group Inc [Member]              
Schedule of Investments [Line Items]              
Equity Method Investment, Ownership Percentage 42.50% 42.50% 42.50%   42.50%    
Residential Healthcare Michigan hospital joint venture [Member] | Residential Healthcare Group Inc [Member]              
Schedule of Investments [Line Items]              
Equity Method Investment, Ownership Percentage 40.00% 40.00% 40.00%   40.00%    
Celtic Healthcare Allegheny Health Network Joint Venture [Member] | Celtic Healthcare [Member]              
Schedule of Investments [Line Items]              
Equity Method Investment, Ownership Percentage 40.00% 40.00% 40.00%   40.00%    
York Joint Venture [Member] | York University [Member]              
Schedule of Investments [Line Items]              
Equity Method Investment, Ownership Percentage 45.00% 45.00% 45.00%   45.00%    
Loan commitment to affiliate | £         £ 25.0    
Advances to Affiliate | £         £ 5.0   £ 11.0
Loan Receivable, Payment Terms     25 years        
Loan Receivable Fixed Interest Rate     7.00%