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Segment Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019 USD ($)	Sep. 30, 2018 USD ($)	Sep. 30, 2019 USD ($) segment	Sep. 30, 2018 USD ($)	Dec. 31, 2018 USD ($)
Segment Reporting Information [Line Items]
Number of reportable segments | segment			5
Revenue	$ 1,008,949	$ 1,120,062	$ 3,070,450	$ 3,462,496
Segment Operating Income	199,084	251,631	665,278	830,217
General and administrative expense (including non-cash stock-based compensation expense)	56,409	58,796	170,296	203,138
Facility lease expense	67,253	70,392	203,610	232,752
Depreciation and amortization	93,550	110,980	284,462	341,351
Goodwill and asset impairment	2,094	5,500	6,254	451,966
Loss (gain) on facility lease termination and modification, net	0	2,337	2,006	148,804
Income (loss) from operations	(20,222)	3,626	(1,350)	(547,794)
Total assets	7,374,203		7,374,203		$ 6,467,260
Operating Segments | Independent Living
Segment Reporting Information [Line Items]
Revenue	136,874	144,631	408,519	462,321
Segment Operating Income	49,414	57,106	153,749	186,662
Total assets	1,461,087		1,461,087		1,104,774
Operating Segments | Assisted Living and Memory Care
Segment Reporting Information [Line Items]
Revenue	452,474	483,125	1,361,225	1,537,432
Segment Operating Income	116,856	144,701	390,699	490,976
Total assets	4,271,885		4,271,885		3,684,170
Operating Segments | CCRCs Rental
Segment Reporting Information [Line Items]
Revenue	100,104	104,147	305,084	314,012
Segment Operating Income	14,472	21,809	53,956	70,291
Total assets	786,825		786,825		707,819
Operating Segments | Health Care Services
Segment Reporting Information [Line Items]
Revenue	111,785	108,276	337,751	328,649
Segment Operating Income	4,778	9,487	22,118	28,008
Total assets	273,943		273,943		254,950
Operating Segments | Management Services
Segment Reporting Information [Line Items]
Revenue	207,712	279,883	657,871	820,082
Segment Operating Income	13,564	$ 18,528	44,756	$ 54,280
Total assets	$ 580,463		$ 580,463		$ 715,547

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