Schedule III - Real Estate and Accumulated Depreciation (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Gross Amount at Which Carried As of Year End
Total	$ 13,137,644	$ 12,592,841	$ 12,524,224	$ 10,616,690
Accumulated Depreciation	(2,250,757)	(1,965,592)	(1,694,892)	(1,408,310)
Post-acute/skilled | Operating segment
Initial Cost to Company
Land	13,434
Buildings and Improvements	162,673
Costs Capitalized Subsequent to Acquisition	31,718
Gross Amount at Which Carried As of Year End
Land	14,102
Buildings and Improvements	187,297
Total	201,399
Accumulated Depreciation	(70,303)
2 Fort Collins CO | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	499
Buildings and Improvements	1,913
Costs Capitalized Subsequent to Acquisition	1,454
Gross Amount at Which Carried As of Year End
Land	499
Buildings and Improvements	3,114
Total	3,613
Accumulated Depreciation	(3,114)
Life on Which Depreciation in Latest Income Statement is Computed	25 years
18 Morrison CO | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	1,429
Buildings and Improvements	5,464
Costs Capitalized Subsequent to Acquisition	4,019
Gross Amount at Which Carried As of Year End
Land	1,429
Buildings and Improvements	8,758
Total	10,187
Accumulated Depreciation	(8,613)
Life on Which Depreciation in Latest Income Statement is Computed	24 years
280 Statesboro GA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	168
Buildings and Improvements	1,508
Gross Amount at Which Carried As of Year End
Land	168
Buildings and Improvements	1,509
Total	1,677
Accumulated Depreciation	(907)
Life on Which Depreciation in Latest Income Statement is Computed	25 years
297 Rexburg ID | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	200
Buildings and Improvements	5,310
Gross Amount at Which Carried As of Year End
Land	200
Buildings and Improvements	5,057
Total	5,257
Accumulated Depreciation	(2,383)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
378 Anderson IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	500
Buildings and Improvements	4,724
Costs Capitalized Subsequent to Acquisition	10,341
Gross Amount at Which Carried As of Year End
Land	1,166
Buildings and Improvements	13,998
Total	15,164
Accumulated Depreciation	(2,628)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
384 Angola IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	130
Buildings and Improvements	2,900
Costs Capitalized Subsequent to Acquisition	2,791
Gross Amount at Which Carried As of Year End
Land	130
Buildings and Improvements	5,691
Total	5,821
Accumulated Depreciation	(1,520)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
385 Fort Wayne IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	200
Buildings and Improvements	4,150
Costs Capitalized Subsequent to Acquisition	2,667
Gross Amount at Which Carried As of Year End
Land	200
Buildings and Improvements	6,817
Total	7,017
Accumulated Depreciation	(2,298)
Life on Which Depreciation in Latest Income Statement is Computed	38 years
386 Fort Wayne IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	140
Buildings and Improvements	3,760
Gross Amount at Which Carried As of Year End
Land	140
Buildings and Improvements	3,760
Total	3,900
Accumulated Depreciation	(1,629)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
387 Huntington IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	30
Buildings and Improvements	2,970
Costs Capitalized Subsequent to Acquisition	338
Gross Amount at Which Carried As of Year End
Land	30
Buildings and Improvements	3,308
Total	3,338
Accumulated Depreciation	(1,346)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
373 Kokomo IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	250
Buildings and Improvements	4,622
Costs Capitalized Subsequent to Acquisition	1,294
Gross Amount at Which Carried As of Year End
Land	250
Buildings and Improvements	5,653
Total	5,903
Accumulated Depreciation	(1,716)
Life on Which Depreciation in Latest Income Statement is Computed	45 years
454 New Albany IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	230
Buildings and Improvements	6,595
Gross Amount at Which Carried As of Year End
Land	230
Buildings and Improvements	6,595
Total	6,825
Accumulated Depreciation	(2,591)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
484 Tell City IN | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	95
Buildings and Improvements	6,208
Costs Capitalized Subsequent to Acquisition	1,299
Gross Amount at Which Carried As of Year End
Land	95
Buildings and Improvements	7,509
Total	7,604
Accumulated Depreciation	(2,140)
Life on Which Depreciation in Latest Income Statement is Computed	45 years
688 Cynthiana KY | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	192
Buildings and Improvements	4,875
Gross Amount at Which Carried As of Year End
Land	192
Buildings and Improvements	4,875
Total	5,067
Accumulated Depreciation	(1,205)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
298 Franklin LA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	405
Buildings and Improvements	3,424
Gross Amount at Which Carried As of Year End
Land	405
Buildings and Improvements	3,424
Total	3,829
Accumulated Depreciation	(2,029)
Life on Which Depreciation in Latest Income Statement is Computed	25 years
299 Morgan City LA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	203
Buildings and Improvements	2,050
Gross Amount at Which Carried As of Year End
Land	203
Buildings and Improvements	2,050
Total	2,253
Accumulated Depreciation	(1,214)
Life on Which Depreciation in Latest Income Statement is Computed	25 years
388 Las Vegas NV | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	1,300
Buildings and Improvements	3,950
Costs Capitalized Subsequent to Acquisition	5,124
Gross Amount at Which Carried As of Year End
Land	1,300
Buildings and Improvements	9,074
Total	10,374
Accumulated Depreciation	(2,091)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
389 Las Vegas NV | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	1,300
Buildings and Improvements	5,800
Gross Amount at Which Carried As of Year End
Land	1,300
Buildings and Improvements	5,800
Total	7,100
Accumulated Depreciation	(2,513)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
390 Fairborn OH | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	250
Buildings and Improvements	4,850
Gross Amount at Which Carried As of Year End
Land	250
Buildings and Improvements	4,850
Total	5,100
Accumulated Depreciation	(2,102)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
391 Georgetown OH | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	130
Buildings and Improvements	4,970
Gross Amount at Which Carried As of Year End
Land	130
Buildings and Improvements	4,970
Total	5,100
Accumulated Depreciation	(2,154)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
392 Port Clinton OH | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	370
Buildings and Improvements	3,630
Gross Amount at Which Carried As of Year End
Land	370
Buildings and Improvements	3,630
Total	4,000
Accumulated Depreciation	(1,573)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
393 Springfield OH | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	250
Buildings and Improvements	3,950
Costs Capitalized Subsequent to Acquisition	2,113
Gross Amount at Which Carried As of Year End
Land	250
Buildings and Improvements	6,063
Total	6,313
Accumulated Depreciation	(2,029)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
394 Toledo OH | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	120
Buildings and Improvements	5,130
Gross Amount at Which Carried As of Year End
Land	120
Buildings and Improvements	5,130
Total	5,250
Accumulated Depreciation	(2,223)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
395 Versailles OH | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	120
Buildings and Improvements	4,980
Gross Amount at Which Carried As of Year End
Land	120
Buildings and Improvements	4,980
Total	5,100
Accumulated Depreciation	(2,158)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
285 Fort Worth TX | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	243
Buildings and Improvements	2,036
Costs Capitalized Subsequent to Acquisition	269
Gross Amount at Which Carried As of Year End
Land	243
Buildings and Improvements	2,305
Total	2,548
Accumulated Depreciation	(1,380)
Life on Which Depreciation in Latest Income Statement is Computed	25 years
296 Ogden UT | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	250
Buildings and Improvements	4,685
Gross Amount at Which Carried As of Year End
Land	250
Buildings and Improvements	4,432
Total	4,682
Accumulated Depreciation	(2,067)
Life on Which Depreciation in Latest Income Statement is Computed	35 years
681 Fishersville VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	751
Buildings and Improvements	7,734
Gross Amount at Which Carried As of Year End
Land	751
Buildings and Improvements	7,220
Total	7,971
Accumulated Depreciation	(1,931)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
682 Floyd VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	309
Buildings and Improvements	2,263
Gross Amount at Which Carried As of Year End
Land	309
Buildings and Improvements	1,893
Total	2,202
Accumulated Depreciation	(805)
Life on Which Depreciation in Latest Income Statement is Computed	25 years
689 Independence VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	206
Buildings and Improvements	8,366
Gross Amount at Which Carried As of Year End
Land	206
Buildings and Improvements	7,810
Total	8,016
Accumulated Depreciation	(2,066)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
683 Newport News VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	535
Buildings and Improvements	6,192
Gross Amount at Which Carried As of Year End
Land	535
Buildings and Improvements	5,719
Total	6,254
Accumulated Depreciation	(1,529)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
684 Roanoke VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	586
Buildings and Improvements	7,159
Gross Amount at Which Carried As of Year End
Land	586
Buildings and Improvements	6,696
Total	7,282
Accumulated Depreciation	(1,789)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
685 Staunton VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	422
Buildings and Improvements	8,681
Gross Amount at Which Carried As of Year End
Land	422
Buildings and Improvements	8,136
Total	8,558
Accumulated Depreciation	(2,173)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
686 Williamsburg VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	699
Buildings and Improvements	4,886
Gross Amount at Which Carried As of Year End
Land	699
Buildings and Improvements	4,464
Total	5,163
Accumulated Depreciation	(1,195)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
690 Windsor VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	319
Buildings and Improvements	7,543
Gross Amount at Which Carried As of Year End
Land	319
Buildings and Improvements	7,018
Total	7,337
Accumulated Depreciation	(1,857)
Life on Which Depreciation in Latest Income Statement is Computed	40 years
687 Woodstock VA | Post-acute/skilled | Operating segment
Initial Cost to Company
Land	603
Buildings and Improvements	5,395
Costs Capitalized Subsequent to Acquisition	9
Gross Amount at Which Carried As of Year End
Land	605
Buildings and Improvements	4,989
Total	5,594
Accumulated Depreciation	$ (1,335)
Life on Which Depreciation in Latest Income Statement is Computed	40 years