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Investments (Narrative) (Details)
3 Months Ended 9 Months Ended 12 Months Ended
Sep. 30, 2019
USD ($)
Jun. 30, 2019
USD ($)
Mar. 31, 2019
USD ($)
Dec. 31, 2018
USD ($)
Sep. 30, 2018
USD ($)
Jun. 30, 2018
USD ($)
Jun. 30, 2018
GBP (£)
Mar. 31, 2018
USD ($)
Sep. 30, 2019
USD ($)
Sep. 30, 2018
USD ($)
Dec. 31, 2018
USD ($)
Dec. 31, 2017
USD ($)
Sep. 30, 2019
GBP (£)
Dec. 31, 2017
GBP (£)
Schedule of Investments [Line Items]                            
Money Market Investments $ 0     $ 75,500,000         $ 0   $ 75,500,000      
Payments to Acquire Marketable Securities                 7,499,000 $ 0        
Gain on marketable equity securities, net                 9,600,000 37,300,000        
Proceeds from sales of marketable equity securities                 17,586,000 66,741,000        
Income from Equity Method Investments 4,683,000 $ 1,467,000 $ 1,679,000 1,426,000 $ 9,537,000 $ 931,000   $ 2,579,000 7,829,000 13,047,000 14,473,000 $ (3,249,000)    
Gain on sale of equity affiliate 0       0       28,994,000 0        
Cost method investments 38,500,000     $ 30,600,000         38,500,000   $ 30,600,000      
Gain on cost method investments 3,669,000   1,300,000   8,487,000       5,080,000 8,487,000        
Impairment of a cost method investment 0       2,500,000       0 2,500,000        
Graham Healthcare Group [Member]                            
Schedule of Investments [Line Items]                            
Revenue from Related Parties $ 2,400,000       2,500,000       $ 7,000,000.0 $ 9,500,000        
Intersection Holdings [Member]                            
Schedule of Investments [Line Items]                            
Equity Method Investment, Ownership Percentage 11.00%               11.00%       11.00%  
Residential Home Health Illinois [Member] | Graham Healthcare Group [Member]                            
Schedule of Investments [Line Items]                            
Equity Method Investment, Ownership Percentage 40.00%               40.00%       40.00%  
Residential Hospice Illinois [Member] | Graham Healthcare Group [Member]                            
Schedule of Investments [Line Items]                            
Equity Method Investment, Ownership Percentage 42.50%               42.50%       42.50%  
Residential Healthcare Michigan hospital joint venture [Member] | Graham Healthcare Group [Member]                            
Schedule of Investments [Line Items]                            
Equity Method Investment, Ownership Percentage 40.00%               40.00%       40.00%  
Celtic Healthcare Allegheny Health Network Joint Venture [Member] | Graham Healthcare Group [Member]                            
Schedule of Investments [Line Items]                            
Equity Method Investment, Ownership Percentage 40.00%               40.00%       40.00%  
Earnings of two investments [Member]                            
Schedule of Investments [Line Items]                            
Income from Equity Method Investments         $ 7,900,000                  
Gimlet Media [Member]                            
Schedule of Investments [Line Items]                            
Gain on sale of equity affiliate     29,000,000.0                      
Proceeds from Sale of Equity Method Investments     $ 33,500,000                      
York Joint Venture [Member] | KIHL [Member]                            
Schedule of Investments [Line Items]                            
Equity Method Investment, Ownership Percentage 45.00%               45.00%       45.00%  
Loan commitment to affiliate | £                         £ 25,000,000  
Advances to Affiliate | £                         £ 22,000,000 £ 16,000,000
Payments to Fund Long-term Loans to Related Parties | £             £ 6,000,000              
Loan Receivable, Payment Terms                 25 years          
Loan Receivable Fixed Interest Rate                 7.00%