CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash Flows from Operating Activities
Net income (loss)	$ (528,352)	$ (571,606)	$ (404,636)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Debt modification and extinguishment costs	11,677	12,409	9,170
Depreciation and amortization, net	455,212	494,758	529,802
Goodwill and asset impairment	489,893	409,782	248,515
Equity in loss (earnings) of unconsolidated ventures	8,804	14,827	(1,660)
Distributions from unconsolidated ventures from cumulative share of net earnings	2,896	8,258	23,544
Amortization of deferred gain	(4,358)	(4,366)	(4,372)
Amortization of entrance fees	(1,670)	(2,901)	(4,195)
Proceeds from deferred entrance fee revenue	3,218	5,712	13,980
Deferred income tax (benefit) provision	(52,367)	(15,309)	3,248
Straight-line lease (income) expense	(17,218)	(20,990)	(6,097)
Change in fair value of derivatives	403	174	178
Gain on sale of assets, net	(293,246)	(19,273)	(7,218)
Loss on facility lease termination and modification, net	140,957	14,276	0
Non-cash stock-based compensation expense	26,067	27,832	32,285
Non-cash interest expense on financing lease obligations	10,894	17,744	26,496
Non-cash management contract termination gain	(8,724)	0	0
Other	(1,292)	(8,819)	(9,137)
Changes in operating assets and liabilities:
Accounts receivable, net	(4,964)	12,747	1,581
Prepaid expenses and other assets, net	26,762	21,970	2,954
Trade accounts payable and accrued expenses	(60,503)	(4,527)	(83,248)
Tenant refundable fees and security deposits	(1,046)	(422)	(839)
Deferred revenue	918	(13,917)	3,300
Net cash provided by operating activities	203,961	378,359	373,651
Cash Flows from Investing Activities
Change in lease security deposits and lease acquisition deposits, net	1,163	(2,113)	(2,225)
Purchase of marketable securities	(14,823)	(341,187)	0
Sale of marketable securities	293,273	50,000	0
Additions to property, plant and equipment and leasehold intangibles, net	(225,473)	(213,887)	(333,647)
Acquisition of assets, net of related payables and cash received	(271,771)	(5,196)	(12,157)
Investment in unconsolidated ventures	(9,124)	(199,017)	(13,377)
Distributions received from unconsolidated ventures	12,850	29,035	218,973
Proceeds from sale of assets, net	499,807	70,507	297,932
Property insurance proceeds	1,292	8,550	9,137
Other	1,580	975	7,162
Net cash provided by (used in) investing activities	288,774	(602,333)	171,798
Cash Flows from Financing Activities
Proceeds from debt	606,921	1,307,205	387,348
Repayment of debt and capital and financing lease obligations	(896,744)	(1,054,161)	(469,309)
Proceeds from line of credit	200,000	100,000	1,276,500
Repayment of line of credit	(200,000)	(100,000)	(1,586,500)
Purchase of treasury stock	(4,256)	0	(9,640)
Payment of financing costs, net of related payables	(16,317)	(17,269)	(10,857)
Proceeds from refundable entrance fees, net of refunds	(422)	(2,179)	(901)
Payments for lease termination	(12,548)	(552)	(9,250)
Payments of employee taxes for withheld shares	(3,061)	(5,889)	(1,640)
Other	1,364	2,043	2,141
Net cash (used in) provided by financing activities	(325,063)	229,198	(422,108)
Net increase in cash, cash equivalents and restricted cash	167,672	5,224	123,341
Cash, cash equivalents and restricted cash at beginning of year	282,546	277,322	153,981
Cash, cash equivalents and restricted cash at end of year	$ 450,218	$ 282,546	$ 277,322