Goodwill and Other Intangible Assets, Net - Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Finite-Lived Intangible Assets [Line Items]
Accumulated Amortization	$ (33,017)	$ (28,188)
Intangible assets, gross carrying amount	97,894	111,195
Intangible assets, net	64,877	83,007
Community Purchase Options [Member]
Finite-Lived Intangible Assets [Line Items]
Indefinite lived assets, gross carrying amount	4,738	4,738
Health care licenses [Member]
Finite-Lived Intangible Assets [Line Items]
Indefinite lived assets, gross carrying amount	51,825	65,126
Trade names [Member]
Finite-Lived Intangible Assets [Line Items]
Finite lived assets, gross carrying amount	27,800	27,800
Accumulated Amortization	(23,070)	(21,135)
Finite lived assets, net	4,730	6,665
Management Contracts [Member]
Finite-Lived Intangible Assets [Line Items]
Finite lived assets, gross carrying amount	13,531	13,531
Accumulated Amortization	(9,947)	(7,053)
Finite lived assets, net	$ 3,584	$ 6,478