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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.

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Amount of accumulated depreciation, depletion and amortization for physical assets used in the normal conduct of business to produce goods and services.

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

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