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Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended |
--- | --- | --- | ---
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Dec. 31, 2017
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | $ 8,825,201 |  | $ 8,825,201 |  | $ 8,916,465
Accumulated depreciation and amortization | (3,109,270) |  | (3,109,270) |  | (3,064,320)
Property, plant and equipment and leasehold intangibles, net | 5,715,931 |  | 5,715,931 |  | 5,852,145
Depreciation and amortization expense | 115,300 | $ 117,900 | 228,700 | $ 244,500 |
Land [Member] |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 473,580 |  | 473,580 |  | 449,295
Buildings and Improvements [Member] |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 5,057,848 |  | 5,057,848 |  | 4,923,621
Leasehold Improvements [Member] |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 121,542 |  | 121,542 |  | 124,850
Furniture and Equipment [Member] |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 1,040,220 |  | 1,040,220 |  | 1,006,889
Resident and Leasehold Operating Intangibles [Member] |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 550,876 |  | 550,876 |  | 594,748
Construction in Progress [Member] |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 50,245 |  | 50,245 |  | 74,678
Assets Under Capital and Financing Leases [Member] |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | $ 1,530,890 |  | $ 1,530,890 |  | $ 1,742,384

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- Definition The current period expense charged against earnings on long-lived, physical assets not used in production, to allocate or recognize the cost of such assets over their useful lives; or to record the reduction in book value of an intangible asset over the benefit period of such asset. + References No definition available. + Details
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- Definition Amount before accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 360 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6391035&loc=d3e2868-110229 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.13) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 + Details
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