Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 8,583,436		$ 8,346,845
Accumulated depreciation and amortization	(3,284,526)		(3,237,011)
Property, plant and equipment and leasehold intangibles, net	5,298,910		5,109,834
Finance lease, right-of-use asset	400,000		600,000
Depreciation and amortization expense	90,700	$ 96,100
Land
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	508,274		450,894
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	5,236,408		4,790,769
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	926,094		859,849
Resident and leasehold operating intangibles
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	317,048		317,111
Construction in progress
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	71,923		80,729
Assets under financing leases and leasehold improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 1,523,689		$ 1,847,493