Goodwill and Other Intangible Assets, Net - Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets, Net [Abstract]
Accumulated Amortization	$ (31,809)	$ (31,643)
Intangible assets, gross carrying amount	92,468	99,620
Intangible assets, net	60,659	67,977
Community Purchase Options [Member]
Indefinite-Lived Intangible Assets (Excluding Goodwill) [Abstract]
Indefinite lived assets, gross carrying amount	4,738	9,533
Health care licenses [Member]
Indefinite-Lived Intangible Assets (Excluding Goodwill) [Abstract]
Indefinite lived assets, gross carrying amount	49,250	50,927
Trade names [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Finite lived assets, gross carrying amount	27,800	27,800
Accumulated Amortization	(24,361)	(23,714)
Finite lived assets, net	3,439	4,086
Management Contracts [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Finite lived assets, gross carrying amount	10,680	11,360
Accumulated Amortization	(7,448)	(7,929)
Finite lived assets, net	$ 3,232	$ 3,431