Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	$ 10,264,151				$ 10,574,411				$ 10,264,151	$ 10,574,411
Accumulated depreciation and amortization	(2,884,846)				(2,543,035)				(2,884,846)	(2,543,035)
Property, plant and equipment and leasehold intangibles, net	7,379,305				8,031,376				7,379,305	8,031,376
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment, non-cash charge	221,877	$ 19,111	$ 4,152	$ 3,375	57,941	$ 0	$ 0	$ 0	248,515	57,941	$ 9,992
Depreciation and amortization expense on property, plant and equipment and leasehold intangibles									514,200	721,000	529,100
Resident And Leasehold Operating Intangibles Future Amortization Expense [Abstract]
2017	9,664								9,664
2018	7,601								7,601
2019	6,209								6,209
2020	4,353								4,353
2021	2,731								2,731
Thereafter	9,958								9,958
Total	40,516								40,516
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	455,307				486,567				455,307	486,567
Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	5,053,204				5,260,826				5,053,204	5,260,826
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	126,325				100,430				126,325	100,430
Furniture and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	974,516				895,447				974,516	895,447
Resident and Leasehold Operating Intangibles [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	705,000				783,434				705,000	783,434
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	69,803				138,054				69,803	138,054
Assets Under Capital and Financing Leases [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles gross	$ 2,879,996				$ 2,909,653				2,879,996	2,909,653
Property, Plant and Equipment [Member]
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment, non-cash charge									166,200	24,300	$ 10,000
Assets held for sale [Member]
Impaired Long-Lived Assets Held and Used [Line Items]
Asset impairment, non-cash charge									$ 15,800	$ 33,600