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Goodwill and Other Intangible Assets, Net - Intangible Assets (Details) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017
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Finite-Lived Intangible Assets, Net [Abstract] |  |
Accumulated Amortization | $ (32,196) | $ (31,643)
Intangible assets, gross carrying amount | 91,849 | 99,620
Intangible assets, net | 59,653 | 67,977
Community purchase options |  |
Indefinite-lived Intangible Assets (Excluding Goodwill) [Abstract] |  |
Indefinite lived assets, gross carrying amount | 4,738 | 9,533
Health care licenses |  |
Indefinite-lived Intangible Assets (Excluding Goodwill) [Abstract] |  |
Indefinite lived assets, gross carrying amount | 49,701 | 50,927
Trade names |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |
Finite lived assets, gross carrying amount | 27,800 | 27,800
Accumulated Amortization | (25,650) | (23,714)
Finite lived assets, net | 2,150 | 4,086
Management contracts |  |
Finite-Lived Intangible Assets, Net [Abstract] |  |
Finite lived assets, gross carrying amount | 9,610 | 11,360
Accumulated Amortization | (6,546) | (7,929)
Finite lived assets, net | $ 3,064 | $ 3,431

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