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Other Contingencies (Details)
1 Months Ended 9 Months Ended 12 Months Ended
Oct. 01, 2011
Jan. 31, 2013
Sep. 30, 2015
USD ($)
financial_covenant
state
Dec. 31, 2016
USD ($)
Oct. 01, 2015
USD ($)
Short-term Debt [Line Items]          
Bank line of credit     $ 200,000,000    
Borrowings under line of credit     0    
Reduction of bank line of credit     $ 75,978,000    
Number of financial covenants | financial_covenant     1    
Credit line, term     5 years    
Line of credit expiration date     Dec. 18, 2018    
Number of states in which entity operates | state     48    
Percentage of reduction to Medicare payments to nursing centers 11.10%        
Forecast          
Short-term Debt [Line Items]          
Percentage Increase Of Medicare Payments To Skilled Nursing Facilities       1.20%  
Monetary Increase Of Medicare Payments To Skilled Nursing Facilities       $ 430,000,000  
Standby Letter Of Credit          
Short-term Debt [Line Items]          
Irrevocable standby letter of credit, outstanding     $ 75,978,000   $ 78,259,000
Maximum          
Short-term Debt [Line Items]          
Percentage of reduction of Medicare payments to plans and providers   2.00%