Increase (Decrease) In Facility Operating Expense

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Increase (Decrease) In Reimbursable Revenue, Net Of Cost Of Reimbursable Expense

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Increase (Decrease) In Reimbursed Costs

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Increase (Decrease) In Resident Fee Revenue, Net Of Facility Operating Expense

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- Definition

Operating Lease Assets (Liabilities)

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Term Of Residency Agreements Maximum

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Term of Residency Agreements- Minimum.

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A valuation allowance for trade and other receivables due to an Entity within one year (or the normal operating cycle, whichever is longer) that are expected to be uncollectible.

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The aggregate costs related to goods produced and sold and services rendered by an entity during the reporting period. This excludes costs incurred during the reporting period related to financial services rendered and other revenue generating activities.

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- Definition

Amount of increase (decrease) in liability to reflect the estimated ultimate cost of settling claims relating to insured events that have occurred on or before the balance sheet date, whether or not reported to the insurer at that date.

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Amount of cash inflow (outflow) from financing activities, including discontinued operations. Financing activity cash flows include obtaining resources from owners and providing them with a return on, and a return of, their investment; borrowing money and repaying amounts borrowed, or settling the obligation; and obtaining and paying for other resources obtained from creditors on long-term credit.

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Amount of cash inflow (outflow) from investing activities, including discontinued operations. Investing activity cash flows include making and collecting loans and acquiring and disposing of debt or equity instruments and property, plant, and equipment and other productive assets.

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Amount of cash inflow (outflow) from operating activities, including discontinued operations. Operating activity cash flows include transactions, adjustments, and changes in value not defined as investing or financing activities.

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Present value of lessee's discounted obligation for lease payments from operating lease.

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Amount of lessee's right to use underlying asset under operating lease.

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Useful life of long lived, physical assets used in the normal conduct of business and not intended for resale, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days. Examples include, but not limited to, land, buildings, machinery and equipment, office equipment, furniture and fixtures, and computer equipment.

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Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

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Summary of Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Jan. 01, 2019
Revenue Recognition
Term of residency agreements - minimum	30 days
Term of residency agreements - maximum	1 year
Accounts Receivable
Allowance for doubtful accounts	$ 24,800	$ 23,100
Self Insurance Reserves
Accrued reserves decreased facility operating expense	14,600	9,900	$ 35,400
ASU Adoption
Increase (decrease) to net cash used in investing activities	288,774	(602,333)	171,798
Increase to net cash provided by operating activities	203,961	378,359	373,651
Increase (decrease) to net cash used in financing activities	(325,063)	229,198	(422,108)
Revenue	3,449,211
ASU 2016-18
ASU Adoption
Increase (decrease) to net cash used in investing activities		1,000	(5,000)
ASU 2016-15
ASU Adoption
Increase to net cash provided by operating activities		11,700	7,900
Increase (decrease) to net cash used in financing activities		(11,700)	7,900
Resident fees
ASU Adoption
Revenue	3,449,211	3,780,140	4,168,621
Facility operating expense
ASU Adoption
Costs incurred	2,453,328	2,602,155	2,799,402
Reimbursed costs incurred on behalf of managed communities
ASU Adoption
Revenue	1,010,229	891,131	737,597
Costs incurred	1,010,229	$ 891,131	$ 737,597
ASU 2014-09
ASU Adoption
Decrease in resident fee revenue	8,400
Decrease in facility operating expense	8,400
Increase in reimbursable revenue	46,100
Increase in reimbursed costs	46,100
ASU 2016-02
ASU Adoption
Net liabilities	$ 200,000
Buildings
Revenue Recognition
Estimated Useful Life	40 years
Subsequent event \| ASU 2016-02
ASU Adoption
Lease liabilities				$ 1,600,000
ROU assets				$ 200,000