Goodwill and Other Intangible Assets, Net - Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets, Net [Abstract]
Accumulated Amortization	$ (33,803)	$ (32,999)
Intangible assets, gross carrying amount	79,733	84,471
Intangible assets, net	45,930	51,472
Community purchase options
Indefinite-lived Intangible Assets (Excluding Goodwill) [Abstract]
Indefinite lived assets, gross carrying amount		4,738
Health care licenses
Indefinite-lived Intangible Assets (Excluding Goodwill) [Abstract]
Indefinite lived assets, gross carrying amount	42,323	42,323
Trade names
Finite-Lived Intangible Assets, Net [Abstract]
Finite lived assets, gross carrying amount	27,800	27,800
Accumulated Amortization	(26,940)	(26,295)
Finite lived assets, net	860	1,505
Management contracts
Finite-Lived Intangible Assets, Net [Abstract]
Finite lived assets, gross carrying amount	9,610	9,610
Accumulated Amortization	(6,863)	(6,704)
Finite lived assets, net	$ 2,747	$ 2,906

Accumulated amount of amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

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- Definition

Amount before amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 928
-SubTopic 340
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6473545&loc=d3e61844-108004

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-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)(1)
-URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275

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Amount after amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

+ References

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- Definition

Amount of assets, excluding financial assets and goodwill, lacking physical substance and having a projected indefinite period of benefit.

+ References

+ Details

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Amount before accumulated amortization of intangible assets, excluding goodwill.

+ References

No definition available.

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- Definition

Sum of the carrying amounts of all intangible assets, excluding goodwill, as of the balance sheet date, net of accumulated amortization and impairment charges.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph ((a)(1),(b))
-URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275

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-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 30
-Section 45
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6388964&loc=d3e16212-109274

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