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Summary of Significant Accounting Policies (Details) (USD $)
 3 Months Ended 12 Months Ended
Dec. 31, 2011
Integer
Sep. 30, 2011
Jun. 30, 2011
Mar. 31, 2011
Dec. 31, 2010
Integer
Sep. 30, 2010
Jun. 30, 2010
Mar. 31, 2010
Dec. 31, 2011
M
Y
D
Integer
Dec. 31, 2010
Integer
Dec. 31, 2009
Current cash and escrow deposits - restricted [Abstract]                      
Real estate taxes $ 12,541,000       $ 9,981,000       $ 12,541,000 $ 9,981,000  
Tenant security deposits 4,374,000       4,591,000       4,374,000 4,591,000  
Insurance reserves 12,904,000       12,728,000       12,904,000 12,728,000  
Entrance Fees 4,891,000       39,785,000       4,891,000 39,785,000  
Replacement reserve and other 11,193,000       12,584,000       11,193,000 12,584,000  
Subtotal 45,903,000       79,669,000       45,903,000 79,669,000  
Long term portion of cash and escrow deposits - restricted [Abstract]                      
Insurance reserves - non-current 5,412,000       6,116,000       5,412,000 6,116,000  
Debt service and other deposits 47,568,000       59,200,000       47,568,000 59,200,000  
Subtotal - non-current 52,980,000       65,316,000       52,980,000 65,316,000  
Total 98,883,000       144,985,000       98,883,000 144,985,000  
Revenue Recognition [Abstract]                      
Term of residency agreements- minimum (in days)                 30    
Term of residency agreements - maximum (in years)                 1    
Refund of resident's entrance fee under certain conditions (in months)                 12    
Deferred revenue 48,100,000       52,900,000       48,100,000 52,900,000  
Time frame for the non-refundable portion of entrance fees expected to be earned and recognized in revenue classified as current liabilities (in years)                 1    
Cash and escrow deposits - Restricted [Abstract]                      
Number of communities located in Illinois required to make escrow deposits 12       10       12 10  
Required deposits, in the form of letters of credit, for communities located in Illinois 20,100,000       19,600,000       20,100,000 19,600,000  
Accounts Receivable [Abstract]                      
Allowance for doubtful accounts 17,000,000       14,500,000       17,000,000 14,500,000  
Finite lived intangible assets - useful lives [Abstract]                      
Amortized cost basis of marketable securities - restricted 32,700,000               32,700,000    
Self insurance liability accruals [Abstract]                      
Insurance deductibles per claim 150,000       150,000       150,000 150,000  
Amount of claims below which the company is self-insured 150,000       150,000       150,000 150,000  
Error Corrections and Prior Period Adjustments Restatement [Line Items]                      
Reimbursed costs incurred on behalf of managed communities                 152,566,000 67,271,000 77,206,000
Total revenue 671,971,000 615,728,000 583,299,000 586,920,000 578,224,000 575,789,000 565,518,000 561,004,000 2,457,918,000 [1] 2,280,535,000 [1] 2,100,274,000 [1]
Costs incurred on behalf of managed communities                 152,566,000 67,271,000 77,206,000
Total operating expense                 2,367,738,000 2,214,541,000 2,070,494,000
Restatement Adjustment [Member]
                      
Error Corrections and Prior Period Adjustments Restatement [Line Items]                      
Reimbursed costs incurred on behalf of managed communities                   67,271,000 77,206,000
Total revenue                   67,271,000 77,206,000
Costs incurred on behalf of managed communities                   67,271,000 77,206,000
Total operating expense                   67,271,000 77,206,000
Scenario, Previously Reported [Member]
                      
Error Corrections and Prior Period Adjustments Restatement [Line Items]                      
Reimbursed costs incurred on behalf of managed communities                   0 0
Total revenue                   2,213,264,000 2,023,068,000
Costs incurred on behalf of managed communities                   0 0
Total operating expense                   2,147,270,000 1,993,288,000
Facility Purchase Options [Member]
                      
Finite lived intangible assets - useful lives [Abstract]                      
Estimated Useful Life (in years)                 40    
Management Contracts and Other [Abstract]
                      
Finite lived intangible assets - useful lives [Abstract]                      
Estimated Useful Life minimum (in years)                 3    
Estimated Useful Life maximum (in years)                 5    
Buildings, improvements, and leasehold improvements [Member]
                      
Estimated useful life of property, plant and equipment [Abstract]                      
Estimated Useful Life (in years)                 40    
Furniture and equipment [Member]
                      
Estimated useful life of property, plant and equipment [Abstract]                      
Estimated Useful Life , minimum (in years)                 3    
Estimated Useful Life , maximum (in years)                 7    
Leasehold Improvements [Member]
                      
Estimated useful life of property, plant and equipment [Abstract]                      
Estimated Useful Life (in years)                
Shorter of the lease term or asset useful life
    
Resident and leasehold operating intangibles [Member]
                      
Estimated useful life of property, plant and equipment [Abstract]                      
Estimated Useful Life , minimum (in years)                 1    
Estimated Useful Life , maximum (in years)                 4    
Leasehold Operating Intangibles [Member]
                      
Estimated useful life of property, plant and equipment [Abstract]                      
Estimated Useful Life (in years)                
Shorter of the lease term or asset useful life
    
Assets under capital and financing leases [Member]
                      
Estimated useful life of property, plant and equipment [Abstract]                      
Estimated Useful Life (in years)                
Shorter of the lease term or asset useful life
    
Carrying (Reported) Amount, Fair Value Disclosure [Member]
                      
Fair value of financial instruments [Abstract]                      
Debt at carrying value 2,500,000,000.0       2,600,000,000.0       2,500,000,000.0 2,600,000,000.0  
Estimate of Fair Value, Fair Value Disclosure [Member]
                      
Fair value of financial instruments [Abstract]                      
Fair value of debt $ 2,500,000,000.0       $ 2,500,000,000.0       $ 2,500,000,000.0 $ 2,500,000,000.0  
[1] All revenue is earned from external third parties in the United States.