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Summary of Significant Accounting Policies (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended |
--- | --- | --- | ---
Sep. 30, 2017 | Sep. 30, 2016 | Sep. 30, 2017 | Sep. 30, 2016 | Dec. 31, 2016
Fair Value of Financial Instruments [Line Items] |  |  |  |  |
Term of residency agreements- minimum |  |  | 30 days |  |
Term of residency agreements - maximum |  |  | 1 year |  |
Decrease in facility operating expense | $ 3,700 | $ 13,900 | $ 9,300 | $ 27,600 |
Decrease in net cash used in investing activities |  |  | 529,718 | 54,374 |
Payments for debt modification and debt extinguishment costs |  |  | 11,200 | 2,900 |
Increase in net cash provided by operating activities |  |  | 283,109 | 277,281 |
Increase (Decrease) in net cash provided by financing activities |  |  | 321,766 | (236,752) |
Cash lease payments |  |  | 275,500 |  |
Carrying Value, Fair Value Disclosure [Member] |  |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |  |
Capital and financing lease obligations | $ 3,900,000 |  | 3,900,000 |  | $ 3,600,000
Accounting Standards Update 2016-18 [Member] |  |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |  |
Decrease in net cash used in investing activities |  |  | 6,300 |  |
Accounting Standards Update 2016-15 [Member] |  |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |  |
Increase in net cash provided by operating activities |  |  | 11,200 | 2,900 |
Increase (Decrease) in net cash provided by financing activities |  |  | $ (11,200) | $ 2,900 |

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- Definition Sum of the carrying values as of the balance sheet date of all debt, including all short-term borrowings, long-term debt, and capital lease obligations. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 942 -SubTopic 210 -Section S99 -Paragraph 1 -Subparagraph (SX 210.9-03.13,16) -URI http://asc.fasb.org/extlink&oid=6876686&loc=d3e534808-122878 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 944 -SubTopic 210 -Section S99 -Paragraph 1 -Subparagraph (SX 210.7-03.16) -URI http://asc.fasb.org/extlink&oid=6879938&loc=d3e572229-122910 + Details
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