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Summary of Significant Accounting Policies (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2017
Sep. 30, 2016
Sep. 30, 2017
Sep. 30, 2016
Dec. 31, 2016
Fair Value of Financial Instruments [Line Items]          
Term of residency agreements- minimum     30 days    
Term of residency agreements - maximum     1 year    
Decrease in facility operating expense $ 3,700 $ 13,900 $ 9,300 $ 27,600  
Decrease in net cash used in investing activities     529,718 54,374  
Payments for debt modification and debt extinguishment costs     11,200 2,900  
Increase in net cash provided by operating activities     283,109 277,281  
Increase (Decrease) in net cash provided by financing activities     321,766 (236,752)  
Cash lease payments     275,500    
Carrying Value, Fair Value Disclosure [Member]          
Fair Value of Financial Instruments [Line Items]          
Capital and financing lease obligations $ 3,900,000   3,900,000   $ 3,600,000
Accounting Standards Update 2016-18 [Member]          
Fair Value of Financial Instruments [Line Items]          
Decrease in net cash used in investing activities     6,300    
Accounting Standards Update 2016-15 [Member]          
Fair Value of Financial Instruments [Line Items]          
Increase in net cash provided by operating activities     11,200 2,900  
Increase (Decrease) in net cash provided by financing activities     $ (11,200) $ 2,900