Derivative Instruments (Details 1) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016		Jun. 30, 2015
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ 0	[1]	$ 58,427
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) on interest rate swaps recalssified from AOCI into income (effective portion)	(477)	(462)	(960)		(928)
Gain (loss) on forward exchange contracts recognized in income.	2,697	1,191	1,369		3,938
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	178,575	(149,436)	175,836		34,615
Derivative Gain Loss On Derivative Net	0	0	0		0
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	0	0	0		0
Foreign Exchange Option Member
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ 0		$ (58,427)

[1] (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.