Derivative Instruments (Details 1) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Derivative [Line Items]
Derivative Gain Loss On Derivative Net		$ 2,448	$ 58,427	$ 1,495
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) on forward exchange contracts recognized in income.		8,544	14,474	0
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI		357,021	298,116	103,140
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment		(2,516)	0	0
Foreign Exchange Option [Member]
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	[1]	$ 0	$ (58,427)	$ 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.