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Increase (Decrease) In Resident Fee Revenue, Net Of Facility Operating Expense

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Operating Lease Assets (Liabilities)

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Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Fair Value Assumptions, Percentage

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Term Of Residency Agreements Maximum

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Term of Residency Agreements- Minimum.

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Amount of allowance for credit loss on accounts receivable, classified as current.

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Amount of write-down of assets recognized in the income statement. Includes, but is not limited to, losses from tangible assets, intangible assets and goodwill.

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The aggregate costs related to goods produced and sold and services rendered by an entity during the reporting period. This excludes costs incurred during the reporting period related to financial services rendered and other revenue generating activities.

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Amount after tax of increase (decrease) to equity or (increase) decrease to net assets, resulting from the cumulative effect adjustment of a new accounting principle applied in the period of adoption.

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Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards.

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Amount of deferred tax assets for which it is more likely than not that a tax benefit will not be realized.

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Amount of receivable from retroactive adjustment for final settlement or appeal due from third-party payor.

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Amount of cash inflow (outflow) from financing activities, including discontinued operations. Financing activity cash flows include obtaining resources from owners and providing them with a return on, and a return of, their investment; borrowing money and repaying amounts borrowed, or settling the obligation; and obtaining and paying for other resources obtained from creditors on long-term credit.

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Amount of cash inflow (outflow) from investing activities, including discontinued operations. Investing activity cash flows include making and collecting loans and acquiring and disposing of debt or equity instruments and property, plant, and equipment and other productive assets.

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Amount of cash inflow (outflow) from operating activities, including discontinued operations. Operating activity cash flows include transactions, adjustments, and changes in value not defined as investing or financing activities.

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Present value of lessee's discounted obligation for lease payments from operating lease.

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Amount of lessee's right to use underlying asset under operating lease.

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Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

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Period over which grantee's right to exercise award under share-based payment arrangement is no longer contingent on satisfaction of service or performance condition, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents reported fact of one year, five months, and thirteen days. Includes, but is not limited to, combination of market, performance or service condition.

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The risk-free interest rate assumption that is used in valuing an option on its own shares.

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Rate of weighted-average expected volatility for award under share-based payment arrangement.

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Percentage of vesting of award under share-based payment arrangement.

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Summary of Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Jan. 01, 2019
Compensation Related Costs [Abstract]
Award vesting period									3 years
Weighted average volatility rate									45.20%
Risk free interest rate									2.40%
Revenue Recognition
Term of residency agreements - minimum									30 days
Term of residency agreements - maximum									1 year
Accounts Receivable
Allowance for doubtful accounts	$ 7,800				$ 7,900				$ 7,800	$ 7,900
Accounts receivable due from third-party payor, retroactive adjustment	17,900				16,900				17,900	16,900
ASU Adoption
Lease liabilities	1,470,765								1,470,765
Operating lease right-of-use assets	1,159,738				0				1,159,738	0
Asset impairment	43,012	$ 2,094	$ 3,769	$ 391	37,927	$ 5,500	$ 16,103	$ 430,363	49,266	489,893	$ 409,782
Deferred tax assets	1,058,559				693,410				1,058,559	693,410
Valuation allowance	$ 408,903				336,417				408,903	336,417
Increase (decrease) to net cash used in investing activities									(225,539)	288,774	(602,333)
Increase to net cash provided by operating activities									216,412	203,961	378,359
Increase (decrease) to net cash used in financing activities									(139,394)	(325,063)	229,198
Revenue									4,057,088	4,531,426	4,747,116
ASU 2016-18
ASU Adoption
Increase (decrease) to net cash used in investing activities											1,000
ASU 2016-15
ASU Adoption
Increase to net cash provided by operating activities											11,700
Increase (decrease) to net cash used in financing activities											(11,700)
Resident fees
ASU Adoption
Revenue									3,209,931	3,449,211	3,780,140
Facility operating expense
ASU Adoption
Costs incurred									2,390,495	2,453,328	2,602,155
Reimbursed costs incurred on behalf of managed communities
ASU Adoption
Revenue									790,049	1,010,229	891,131
Costs incurred									790,049	1,010,229	$ 891,131
ASU 2016-02
ASU Adoption
Lease liabilities												$ 1,618,000
Operating lease right-of-use assets												1,329,000
Net liabilities					(231,400)					(231,400)
Cumulative effect of change in accounting principle												58,100
Deferred tax assets					300					300		14,100
Valuation allowance												13,800
ASU 2014-09
Accounts Receivable
Accounts receivable due from third-party payor, retroactive adjustment					$ 13,300					13,300
ASU Adoption
Decrease in resident fee revenue										(8,400)
Increase (decrease) in facility operating expense										46,100
ASU 2014-09 \| Resident fees
ASU Adoption
Revenue										3,400,000
ASU 2014-09 \| Facility operating expense
ASU Adoption
Costs incurred										2,500,000
ASU 2014-09 \| Reimbursed costs incurred on behalf of managed communities
ASU Adoption
Revenue										1,000,000
Costs incurred										$ 1,000,000
Accounting Standards Update 2016-02, Impairment Loss [Member]
ASU Adoption
Cumulative effect of change in accounting principle												$ 58,100
Asset impairment									$ 10,200
Minimum
Compensation Related Costs [Abstract]
Award vesting period									3 years
Award vesting rights percentage									0.00%
Fair value vesting rights, percentage									0.00%
Maximum
Compensation Related Costs [Abstract]
Award vesting period									4 years
Award vesting rights percentage									125.00%
Fair value vesting rights, percentage									150.00%