Summary of Significant Accounting Policies (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Jan. 01, 2019	Dec. 31, 2018
Revenue Recognition [Abstract]
Term of residency agreements- minimum	30 days
Term of residency agreements - maximum	1 year
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
Total lease obligations	$ 1,508,393
Operating lease right-of-use assets	1,221,578		$ 0
Change in valuation allowance	$ 387,900		336,400
ASU 2016-02
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
Total lease obligations		$ 1,618,000
Operating lease right-of-use assets		1,329,000
Operating lease assets (liabilities)			(231,400)
Cumulative effect change in accounting principle		58,100
Deferred tax assets		14,100	$ 300
Change in valuation allowance		13,800
ASU 2016-02, Impairment Loss
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
Cumulative effect change in accounting principle		$ 58,100