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Summary of Significant Accounting Policies (Details) - USD ($) $ in Thousands | 9 Months Ended |  |
--- | --- | --- | ---
Sep. 30, 2019 | Jan. 01, 2019 | Dec. 31, 2018
Revenue Recognition [Abstract] |  |  |
Term of residency agreements- minimum | 30 days |  |
Term of residency agreements - maximum | 1 year |  |
New Accounting Pronouncements and Changes in Accounting Principles [Abstract] |  |  |
Total lease obligations | $ 1,508,393 |  |
Operating lease right-of-use assets | 1,221,578 |  | $ 0
Change in valuation allowance | $ 387,900 |  | 336,400
ASU 2016-02 |  |  |
New Accounting Pronouncements and Changes in Accounting Principles [Abstract] |  |  |
Total lease obligations |  | $ 1,618,000 |
Operating lease right-of-use assets |  | 1,329,000 |
Operating lease assets (liabilities) |  |  | (231,400)
Cumulative effect change in accounting principle |  | 58,100 |
Deferred tax assets |  | 14,100 | $ 300
Change in valuation allowance |  | 13,800 |
ASU 2016-02, Impairment Loss |  |  |
New Accounting Pronouncements and Changes in Accounting Principles [Abstract] |  |  |
Cumulative effect change in accounting principle |  | $ 58,100 |

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