Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	$ 10,412,214		$ 10,412,214		$ 10,574,411
Accumulated depreciation and amortization	(2,720,736)		(2,720,736)		(2,543,035)
Property, plant and equipment and leasehold intangibles, net	7,691,478		7,691,478		8,031,376
Asset impairment, non-cash charge	4,152	$ 0	7,527	$ 0
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	454,263		454,263		486,567
Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	5,120,742		5,120,742		5,260,826
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	116,810		116,810		100,430
Furniture and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	937,658		937,658		895,447
Resident and Leasehold Operating Intangibles [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	765,859		765,859		783,434
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	83,552		83,552		138,054
Assets Under Capital and Financing Leases [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	2,933,330		2,933,330		$ 2,909,653
Property, Plant and Equipment [Member]
Property, Plant and Equipment [Line Items]
Asset impairment, non-cash charge	1,800		2,500
Assets held for sale [Member]
Property, Plant and Equipment [Line Items]
Asset impairment, non-cash charge	$ 2,400		$ 5,000