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Summary of Significant Accounting Policies (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended
--- | --- | ---
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017
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 | $ (6,300) | $ (2,000) | $ (7,500) | $ (5,600)
Decrease in net cash used in investing activities |  |  | (11,512) | 259,494
Increase in net cash provided by operating activities |  |  | 98,584 | 200,532
Decrease in net cash used in financing activities |  |  | 201,980 | 4,186
Revenue | 895,969 | 934,070 | $ 1,802,235 | 1,950,997
Trade names | Minimum |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Useful lives of definite lived assets |  |  | 2 years |
Trade names | Maximum |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Useful lives of definite lived assets |  |  | 5 years |
Management contracts | Minimum |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Useful lives of definite lived assets |  |  | 3 years |
Management contracts | Maximum |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Useful lives of definite lived assets |  |  | 9 years |
ASU 2016-18 |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Decrease in net cash used in investing activities |  | 1,100 |  | 1,700
ASU 2016-15 |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Increase in net cash provided by operating activities |  | 700 |  | 700
Decrease in net cash used in financing activities |  | 700 |  | 700
ASU 2014-09 |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Decrease in resident fee revenue and facility operating expenses | 2,100 |  | $ 3,200 |
Increase in revenue | 11,300 |  | 23,700 |
Resident fees |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Revenue | 895,969 | 934,070 | 1,802,235 | 1,950,997
Facility operating |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Costs of services | 627,076 | 642,405 | 1,259,401 | 1,316,947
Reimbursed costs incurred on behalf of managed communities |  |  |  |
Fair Value of Financial Instruments [Line Items] |  |  |  |
Costs of services | 242,160 | 229,960 | 504,447 | 413,905
Revenue | $ 242,160 | $ 229,960 | $ 504,447 | $ 413,905

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