Derivative Instruments (Details 1) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 2,516	$ 0	$ 2,516	$ 58,427
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) on forward exchange contracts recognized in income.	3,420	2,347	4,789	6,285
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	53,421	174,239	229,256	208,854
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	(2,516)	0	(2,516)	0
Foreign Exchange Option Member
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ 0	$ (58,427)	[1]

[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.