Supplemental Disclosure of Cash Flow Information (Details) (USD $) In Thousands	9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010
Acquisition of assets, net of related payables and cash received [Abstract]
Interest paid	$ 90,581	$ 99,898
Income taxes paid	2,283	1,122
Write-off of deferred costs	2,080	2,878
Horizon Bay Realty LLC [Member]
Acquisition of assets, net of related payables and cash received [Abstract]
Property, plant and equipment and leasehold intangibles, net	8,201	0
Cash and escrow deposits - restricted	10,702	0
Accounts receivable, net	2,065	0
Long-term debt, less current portion	(1,821)	0
Trade accounts payable	(142)	0
Accrued expenses	(13,157)	0
Refundable entrance fees and deferred revenue	(237)	0
Tenant security deposits	(157)	0
Deferred entrance fee revenue	(870)	0
Deferred liabilities	(503)	0
Deferred income taxes	(1,387)	0
Other long-term liabilities	(3,152)	0
Common stock	(1)	0
Additional paid-in capital	(1,537)	0
Accumulated earnings	(3,520)	0
Net	(5,516)	0
Series Of Individually Immaterial Business Acquisitions [Member]
Acquisition of assets, net of related payables and cash received [Abstract]
Property, plant and equipment and leasehold intangibles, net	50,350	19,900
Other intangible assets, net	4,247	6,310
Accrued expenses	0	(94)
Net	$ 54,597	$ 26,116