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Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share / (Unit)-based compensation expense	$ 16,505	$ 9,949	$ 7,942
Stock-based compensation expense, unrecognized cost	$ 34,900
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	2 years 1 month 6 days
Restricted equity awards, fair value	$ 8,400	$ 10,400	$ 12,700
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years	10 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of common stock for awards under the Equity Incentive Plan	8,196,770,000
Common stock remaining for future stock awards transferred to the equity incentive plan	976,073,000
Maximum number of shares of common stock that may be awarded	5,000,000,000
Service-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)	3 years
40% of 2018 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual total shareholder return (in years)	1 year
Stock-based awards expiration date	Dec. 31, 2020
Percentage of performance award grant in period	40.00%
EBITDA achieving period	1 year
40% of 2018 Performance Awards [Member] \| Return on Equity Equal to 12.5% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	12.50%
40% of 2018 Performance Awards [Member] \| Return on Equity Greater than or Equal to 13.5% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	13.50%
Percentage of performance award to be earned of shareholder return reaches shareholder limit	200.00%
40% of 2018 Performance Awards [Member] \| EBITDA Equal to $720 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
EBITDA to be earned	$ 720,000
Percentage of performance award to be earned if EBITDA reaches limit	50.00%
40% of 2018 Performance Awards [Member] \| EBITDA Equal to $775 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
EBITDA to be earned	$ 775,000
Percentage of performance award to be earned if EBITDA reaches limit	50.00%
40% of 2018 Performance Awards [Member] \| EBITDA Equal to $740 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
EBITDA to be earned	$ 740,000
Percentage of performance award to be earned if EBITDA reaches limit	100.00%
40% of 2018 Performance Awards [Member] \| EBITDA Equal to $800 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
EBITDA to be earned	$ 800,000
Percentage of performance award to be earned if EBITDA reaches limit	100.00%
40% of 2018 Performance Awards [Member] \| EBITDA Equal to $760 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
EBITDA to be earned	$ 760,000
Percentage of performance award to be earned if EBITDA reaches limit	200.00%
40% of 2018 Performance Awards [Member] \| EBITDA Equal to $825 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
EBITDA to be earned	$ 825,000
Percentage of performance award to be earned if EBITDA reaches limit	200.00%
40% of 2018 Performance Awards [Member] \| Maximum [Member] \| Return on Equity Equal to 12.5% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
40% of 2018 Performance Awards [Member] \| Minimum [Member] \| Return on Equity Equal to 12.5% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of performance award to be earned of shareholder return reaches shareholder limit	50.00%
20% of 2018 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based awards expiration date	Dec. 31, 2020
Percentage of performance award grant in period	20.00%
Acquisition achieving period	1 year
20% of 2018 Performance Awards [Member] \| Acquisitions Equal to $500 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Acquisitions	$ 500,000
Percentage of performance award to be earned if acquisitions reaches threshold limit	50.00%
20% of 2018 Performance Awards [Member] \| Acquisitions Equal to $1.5 Billion [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Acquisitions	$ 1,500,000
Percentage of performance award to be earned if acquisitions reaches threshold limit	50.00%
20% of 2018 Performance Awards [Member] \| Acquisitions Equal to $750 Million [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Acquisitions	$ 750,000
Percentage of performance award to be earned if acquisitions reaches threshold limit	100.00%
20% of 2018 Performance Awards [Member] \| Acquisitions Equal to $2.25 Billion [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Acquisitions	$ 2,250,000
Percentage of performance award to be earned if acquisitions reaches threshold limit	100.00%
20% of 2018 Performance Awards [Member] \| Acquisitions Equal to $1.0 Billion [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Acquisitions	$ 1,000,000
Percentage of performance award to be earned if acquisitions reaches threshold limit	200.00%
20% of 2018 Performance Awards [Member] \| Acquisitions Equal to $3.0 Billion [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Acquisitions	$ 3,000,000
Percentage of performance award to be earned if acquisitions reaches threshold limit	200.00%
Final Portion of 2018 Performance Awards [Member] \| SNL Index, Greater than Seventy Five Percent [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	75.00%
Increase (decrease) in percentage of performance award to be earned If shareholder return reaches shareholder limit	25.00%
Final Portion of 2018 Performance Awards [Member] \| SNL Index, Greater than Fifty Five Percent [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	55.00%
Increase (decrease) in percentage of performance award to be earned If shareholder return reaches shareholder limit	0.00%
Final Portion of 2018 Performance Awards [Member] \| SNL Index, Greater than Thirty Five Percent [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	35.00%
Increase (decrease) in percentage of performance award to be earned If shareholder return reaches shareholder limit	(25.00%)
Final Portion of 2018 Performance Awards [Member] \| SNL Index, Greater than Ninety Five Percent [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	95.00%
2018 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	2,000
Number of performance awards earned and unvested	508,566
Number of performance awards to be earned	1,238,748
42% of 2017 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)		3 years
Annual total shareholder return (in years)		1 year
Stock-based awards expiration date		Dec. 31, 2017
Percentage of performance award grant in period		42.00%
Share based payment award, weighted average risk-free rate of return		1.00%
Share based payment award, expected volatility rate		25.00%
Common stock options awarded, dividend yield		6.90%
42% of 2017 Performance Awards [Member] \| U.S. REIT Healthcare Index Minus 3% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		3.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit		50.00%
42% of 2017 Performance Awards [Member] \| U.S. REIT Healthcare Index Plus 3% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		3.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit		200.00%
47% of 2017 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual total shareholder return (in years)		1 year
Stock-based awards expiration date		Dec. 31, 2017
Percentage of performance award grant in period		47.00%
47% of 2017 Performance Awards [Member] \| Return on Equity Equal to 12.5% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		12.50%
Percentage of performance award to be earned of shareholder return reaches shareholder limit		50.00%
47% of 2017 Performance Awards [Member] \| Return on Equity Greater than or Equal to 13.5% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		13.50%
Percentage of performance award to be earned of shareholder return reaches shareholder limit		200.00%
11% of 2017 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual total shareholder return (in years)		1 year
Stock-based awards expiration date		Dec. 31, 2017
Percentage of performance award to be earned of shareholder return reaches shareholder limit		11.00%
11% of 2017 Performance Awards [Member] \| General and Administrative Expense to Revenue Ratio Equal to 10% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of performance award to be earned if G&A stays at or below limit		50.00%
11% of 2017 Performance Awards [Member] \| General and Administrative Expense to Revenue Ratio is Less Than Equal to 9% [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of performance award to be earned if G&A stays at or below limit		200.00%
G&A as a percentage of revenue threshold		9.00%
11% of 2017 Performance Awards [Member] \| General and Administrative Expenses to Revenue Ratio Less Than Equal to Ten Percent [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
G&A as a percentage of revenue threshold		10.00%
65% of 2017 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)		5 years
Share based payment award, weighted average risk-free rate of return		1.90%
Share based payment award, expected volatility rate		25.00%
Common stock options awarded, dividend yield		6.90%
65% of 2017 Performance Awards [Member] \| 2019 Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based awards expiration date		Dec. 31, 2019
Percentage of performance award to be earned of shareholder return reaches shareholder limit		30.00%
65% of 2017 Performance Awards [Member] \| 2020 Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based awards expiration date		Dec. 31, 2020
Percentage of performance award to be earned of shareholder return reaches shareholder limit		30.00%
65% of 2017 Performance Awards [Member] \| 2019 and 2020 Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based awards expiration date		Dec. 31, 2021
65% of 2017 Performance Awards [Member] \| Maximum [Member] \| 2019 and 2020 Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of performance award to be earned of shareholder return reaches shareholder limit		30.00%
65% of 2017 Performance Awards [Member] \| Minimum [Member] \| 2019 Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		27.00%
65% of 2017 Performance Awards [Member] \| Minimum [Member] \| 2020 Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		36.00%
65% of 2017 Performance Awards [Member] \| Minimum [Member] \| 2019 and 2020 Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		45.00%
Final Portion of 2017 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)		3 years
Stock-based awards expiration date		Dec. 31, 2019
Share based payment award, weighted average risk-free rate of return		1.50%
Share based payment award, expected volatility rate		25.00%
Common stock options awarded, dividend yield		6.90%
Share-based compensation award vesting rights	Vest in equal annual amounts on January 1, 2020, 2021, and 2022.
Final Portion of 2017 Performance Awards [Member] \| SNL Index, Greater than Three Percent [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		3.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
2017 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	3,750	14,000
Number of performance awards earned and unvested	396,142	596,472
Number of performance awards to be earned	1,125,281
50% of 2016 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)			5 years
Stock-based awards expiration date		Dec. 31, 2018
Percentage of performance award grant in period			50.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
Share based payment award, weighted average risk-free rate of return			1.00%
Share based payment award, expected volatility rate			24.40%
Common stock options awarded, dividend yield			7.00%
50% of 2016 Performance Awards [Member] \| If Any Shares are Earned from this Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on January 1, 2019, 2020, and 2021.
50% of 2016 Performance Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			35.00%
50% of 2016 Performance Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			27.00%
Remaining % of 2016 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)			5 years
Stock-based awards expiration date	Dec. 31, 2018
Share based payment award, weighted average risk-free rate of return			1.00%
Share based payment award, expected volatility rate			24.40%
Common stock options awarded, dividend yield			7.00%
Remaining % of 2016 Performance Awards [Member] \| If Any Shares are Earned from this Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on January 1, 2019, 2020, and 2021.
Remaining % of 2016 Performance Awards [Member] \| Within Three Percent of MSCI Index [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			3.00%
Remaining % of 2016 Performance Awards [Member] \| MSCI Index Plus Three Percent [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			300.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
2016 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	0	16,000	2,400
Number of performance awards to be earned		0	0
Number of performance awards earned and unvested	779,004