Components of Secured Loans,Unsecured Notes Payable and Line of Credit (Detail) (USD $) In Thousands, unless otherwise specified	Sep. 30, 2014	Dec. 31, 2013
Debt Instrument [Line Items]
Term loan and other notes payable	$ 840,888	$ 686,406
HUD Loan
Debt Instrument [Line Items]
Term loan and other notes payable	13,478	13,654
2019 Notes
Debt Instrument [Line Items]
Term loan and other notes payable	402,410	402,752
2021 Notes
Debt Instrument [Line Items]
Term loan and other notes payable	250,000	250,000
Unsecured Revolving Credit Facility
Debt Instrument [Line Items]
Term loan and other notes payable	175,000
Revolving Credit Facility
Debt Instrument [Line Items]
Term loan and other notes payable		$ 20,000

Amount of long-term debt before deduction of unamortized discount or premium. Includes, but is not limited to, notes payable, bonds payable, commercial loans, mortgage loans, convertible debt, subordinated debt and other types of debt, with initial maturities beyond one year or the normal operating cycle, if longer.

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 02

-Paragraph 20

-Article 5

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 02

-Paragraph 22

-Article 5

Reference 3: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section S99

-Paragraph 1

-Subparagraph (SX 210.5-02.22)

-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 4: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 03

-Paragraph 16

-Article 9

Name:	us-gaap_DebtInstrumentCarryingAmount
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	instant