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Property, Plant and Equipment and Leasehold Intangibles, Net (Details) (USD $)
In Thousands, unless otherwise specified
Sep. 30, 2014
Dec. 31, 2013
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross $ 10,264,942 $ 5,717,731
Accumulated depreciation and amortization (1,691,384) (1,822,256)
Property, plant and equipment and leasehold intangibles, net 8,573,558 3,895,475
Land [Member]
    
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross 474,425 302,444
Buildings and Improvements [Member]
    
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross 5,021,617 3,508,693
Leasehold Improvements [Member]
    
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross 65,750 59,948
Furniture and Equipment [Member]
    
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross 698,205 623,352
Resident and Leasehold Operating Intangibles [Member]
    
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross 840,891 435,012
Construction in Progress [Member]
    
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross 107,810 88,309
Assets Under Capital and Financing Leases [Member]
    
Property, Plant and Equipment [Line Items]    
Property, plant and equipment and leasehold intangibles, gross $ 3,056,244 $ 699,973