CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Cash flows from operating activities:
Net (loss) income	$ (2,340)	$ 22,307	$ 72,174
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	28,109	24,480	19,160
Loss (gain) on early extinguishment of debt	599	(45)	(1)
Loss (income) from discontinued operations	9,327	(17,158)	6,184
Loss (gain) on sale of available for sale securities	5	19	(4,116)
Impairment of long-lived assets	186		3,080
Equity in earnings of an investee	(334)	(316)	(139)
Stock-based compensation	1,410	1,445	1,173
Deferred income taxes	(2,793)	10,560	(62,031)
Provision for losses on receivables	6,412	4,446	4,197
Changes in assets and liabilities:
Accounts receivable	(4,147)	(2,431)	(8,344)
Prepaid expenses and other assets	2,334	(11,357)	(1,109)
Accounts payable and accrued expenses	(2,565)	18,623	5,283
Accrued compensation and benefits	(3,414)	1,403	2,770
Due (from) to related persons	(1,074)	(6,773)	1,371
Other current and long term liabilities	4,062	2,305	2,384
Cash provided by operating activities	35,777	47,508	42,036
Cash flows from investing activities:
Payments from restricted cash and investment accounts, net	(84)	(9,784)	(2,570)
Acquisition of property and equipment	(53,766)	(51,805)	(57,451)
Acquisition of senior living communities, net of working capital liabilities assumed			(107,765)
Purchase of available for sale securities	(13,974)	(5,076)	(206)
Proceeds from disposition of property and equipment	24,641	24,818	31,317
Proceeds from sale of available for sale securities	6,285	4,163	10,896
Cash used in investing activities	(36,898)	(37,684)	(125,779)
Cash flows from financing activities:
Net proceeds from the issuance of common stock			53,953
Proceeds from borrowings on credit facilities	85,000	62,500	12,000
Repayments of borrowings on credit facilities	(50,000)	(62,500)	(12,000)
Proceeds from borrowings on a bridge loan from SNH			80,000
Repayments of borrowings on a bridge loan from SNH		(38,000)	(42,000)
Purchase and retirement of convertible senior notes	(24,872)	(12,038)	(622)
Repayments of mortgage notes payable	(1,093)	(1,028)	(548)
Cash provided by (used in) financing activities	9,035	(51,066)	90,783
Cash flows from discontinued operations:
Net cash (used in) provided by discontinued operations	(7,000)	1,763	2,405
Net cash provided by (used in) investing activities	5,610	35,885	(1,706)
Net cash used in financing activities	(7,534)	(142)	(135)
Net cash flows (used in) provided by discontinued operations	(8,924)	37,506	564
Change in cash and cash equivalents	(1,010)	(3,736)	7,604
Cash and cash equivalents at beginning of period	24,638	28,374	20,770
Cash and cash equivalents at end of period	23,628	24,638	28,374
Supplemental cash flow information:
Cash paid for interest	3,361	4,921	3,540
Cash paid for income taxes	1,884	2,132	1,336
Non-cash activities:
Real estate acquisition			(40,289)
Assumption of mortgage note payable			$ 40,289