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Supplemental Disclosure of Cash Flow Information - Non-cash, Investing and Financing Activities (Details) - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Dec. 31, 2017
Sep. 30, 2017
Jun. 30, 2017
Mar. 31, 2017
Dec. 31, 2016
Sep. 30, 2016
Jun. 30, 2016
Mar. 31, 2016
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Cash Flow, Noncash Investing and Financing Activities Disclosure [Abstract]                      
Prepaid expenses and other assets                 $ (21,970) $ (2,954) $ (51,079)
Goodwill $ 505,783       $ 705,476       505,783 705,476  
Asset impairment 18,966 $ 368,551 $ 1,559 $ 20,706 221,877 $ 19,111 $ 4,152 $ 3,375 409,782 248,515 57,941
Assets held for sale                      
Cash Flow, Noncash Investing and Financing Activities Disclosure [Abstract]                      
Prepaid expenses and other assets                 199 (3,195) 0
Assets held for sale                 (29,544) 278,675 110,620
Property, plant and equipment and leasehold intangibles, net                 29,345 (262,711) (113,592)
Goodwill 0       (28,568)       0 (28,568) (12,200)
Asset impairment                 0 15,799 15,172
Net                 0 0 0
Amendments to leases                      
Cash Flow, Noncash Investing and Financing Activities Disclosure [Abstract]                      
Property, plant and equipment and leasehold intangibles, net                 (145,645) 0 26,644
Other intangible assets, net                 0 0 (5,202)
Capital and financing lease obligations                 147,886 0 (23,738)
Deferred liabilities                 7,447 0 0
Other liabilities                 (9,688) 0 2,296
Net                 0 0 0
Contribution to CCRC Venture                      
Cash Flow, Noncash Investing and Financing Activities Disclosure [Abstract]                      
Property, plant and equipment and leasehold intangibles, net                 0 0 (25,717)
Investment in unconsolidated ventures $ 0       $ 0       0 0 7,422
Long-term debt                 0 0 18,295
Net                 $ 0 $ 0 $ 0