Commitments and Contingencies (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2015 USD ($) Community Lease	Dec. 31, 2014 USD ($) Community Lease	Dec. 31, 2013 USD ($)
Commitments and Contingencies [Abstract]
Initial lease terms, minimum	10 years
Initial lease terms, maximum	20 years
Renewal options, minimum	5 years
Renewal options, maximum	30 years
Number of communities operated under long-term leases | Community	546	583
Number of operating leases | Lease	322	342
Number of capital and financing leases | Lease	224	241
Remaining base lease terms, minimum	1 year
Remaining base lease terms, maximum	17 years
Schedule of facility operating lease expense [Abstract]
Cash basis payment	$ 372,148	$ 330,207	$ 278,504
Straight-line expense	6,956	1,439	2,597
Amortization of (above) below market rent, net	(7,158)	(3,444)	0
Amortization of deferred gain	(4,372)	(4,372)	(4,372)
Facility lease expense	367,574	$ 323,830	$ 276,729
Future minimum operating lease payments [Abstract]
2016	390,816
2017	373,690
2018	358,168
2019	340,747
2020	300,674
Thereafter	1,336,099
Total	$ 3,100,194