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Derivative Instruments (Details 1) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2015
Dec. 31, 2014
Dec. 31, 2013
Derivative [Line Items]      
Derivative Gain Loss On Derivative Net $ 58,427 $ 1,495 $ (4,470)
Interest Rate Swap [Member]      
Derivative [Line Items]      
Gain (loss) on forward exchange contracts recognized in income. 14,474 0 0
Foreign Exchange Contract [Member]      
Derivative [Line Items]      
Gain (loss) recognized in OCI 298,116 103,140 (28,244)
Derivative Gain Loss On Derivative Net 0 1,495 (4,470)
Foreign Exchange Option [Member]      
Derivative [Line Items]      
Derivative Gain Loss On Derivative Net [1] $ (58,427) $ 0 $ 0
[1] In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.