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Property, Plant and Equipment and Leasehold Intangibles, Net (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
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross $ 9,183,049   $ 9,183,049   $ 10,264,151
Accumulated depreciation and amortization (3,002,673)   (3,002,673)   (2,884,846)
Property, plant and equipment and leasehold intangibles, net 6,180,376   6,180,376   7,379,305
Asset impairment, non-cash charge 368,551 $ 19,111 390,816 $ 26,638  
Land [Member]          
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross 449,295   449,295   455,307
Buildings and Improvements [Member]          
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross 4,911,597   4,911,597   5,053,204
Asset impairment, non-cash charge 149,900   152,400    
Leasehold Improvements [Member]          
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross 126,185   126,185   126,325
Furniture and Equipment [Member]          
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross 995,975   995,975   974,516
Resident and Leasehold Operating Intangibles [Member]          
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross 609,518   609,518   705,000
Construction in Progress [Member]          
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross 52,003   52,003   69,803
Assets Under Capital and Financing Leases [Member]          
Property, Plant and Equipment [Line Items]          
Property, plant and equipment and leasehold intangibles gross $ 2,038,476   2,038,476   $ 2,879,996
Assisted Living [Member]          
Property, Plant and Equipment [Line Items]          
Asset impairment, non-cash charge     133,700    
CCRCs Rental [Member]          
Property, Plant and Equipment [Line Items]          
Asset impairment, non-cash charge     16,200    
Retirement Centers [Member]          
Property, Plant and Equipment [Line Items]          
Asset impairment, non-cash charge     $ 2,500    
Minimum [Member]          
Property, Plant and Equipment [Line Items]          
Capitalization rate 6.50%   6.50%    
Maximum [Member]          
Property, Plant and Equipment [Line Items]          
Capitalization rate 9.00%   9.00%