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Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended |
--- | --- | --- | ---
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | Dec. 31, 2018
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | $ 8,349,146 |  | $ 8,349,146 |  | $ 8,322,802
Accumulated depreciation and amortization | (3,163,465) |  | (3,163,465) |  | (3,047,375)
Property, plant and equipment and leasehold intangibles, net | 5,185,681 |  | 5,185,681 |  | 5,275,427
Finance lease, right-of-use asset | 600,000 |  | 600,000 |  | 700,000
Depreciation and amortization expense | 93,300 | $ 110,400 | 282,600 | $ 339,000 |
Land |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 454,790 |  | 454,790 |  | 455,623
Buildings and improvements |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 4,812,422 |  | 4,812,422 |  | 4,749,877
Furniture and equipment |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 849,573 |  | 849,573 |  | 805,190
Resident and leasehold operating intangibles |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 319,049 |  | 319,049 |  | 477,827
Construction in progress |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | 80,788 |  | 80,788 |  | 57,636
Assets under financing leases and leasehold improvements |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |
Property, plant and equipment and leasehold intangibles gross | $ 1,832,524 |  | $ 1,832,524 |  | $ 1,776,649

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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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