Facility Operating Leases (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018 USD ($) lease	Jun. 30, 2017 USD ($)	Jun. 30, 2018 USD ($) lease	Jun. 30, 2017 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Number of communities operated under long-term leases | lease	385		385
Number of operating leases | lease	258		258
Number of capital and financing leases | lease	127		127
Schedule of facility operating lease expense [Abstract]
Cash basis payment	$ 87,115	$ 90,599	$ 176,708	$ 185,203
Straight-line (income) expense	(2,430)	(3,119)	(8,595)	(6,126)
Amortization of (above) below market lease, net	(1,636)	(1,697)	(3,574)	(3,394)
Amortization of deferred gain	(1,089)	(1,093)	(2,179)	(2,186)
Facility lease expense	$ 81,960	$ 84,690	$ 162,360	$ 173,497