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Supplemental Disclosure of Cash Flow Information (Details) - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2020 | Mar. 31, 2019
Supplemental Cash Flow Information [Abstract] |  |
Interest paid | $ 59,479 | $ 62,107
Income taxes paid, net of refunds | 957 | 606
Net cash paid | 69,385 | 60,055
Gain (loss) on debt modification and extinguishment, net | 19,181 | (67)
Investment in unconsolidated ventures | (268) | (3,986)
Loss (gain) on sale of assets, net | (372,839) | 702
Prepaid expenses and other assets, net | (1,696) | 12,358
Loss (gain) on facility lease termination and modification, net | 0 | 209
Additions to property, plant and equipment and leasehold improvements |  |
Supplemental Cash Flow Information [Abstract] |  |
Net cash paid | 69,385 | 60,055
Trade accounts payable | (898) | 184
Acquisition of communities from Healthpeak |  |
Supplemental Cash Flow Information [Abstract] |  |
Property, plant and equipment and leasehold intangibles, net | 286,734 | 0
Operating lease right-of-use assets | 63,285 | 0
Financing lease obligations | 129,196 | 0
Operating lease obligations | 74,335 | 0
Gain (loss) on debt modification and extinguishment, net | 19,731 | 0
Net cash paid | 407,249 | 0
Acquisition of assets, net of related payables and cash received |  |
Supplemental Cash Flow Information [Abstract] |  |
Property, plant and equipment and leasehold intangibles, net | 179 | 32,126
Net cash paid | 39,439 | 27,330
Financing lease right-of-use assets | 39,260 | 0
Other intangibles assets, net | 0 | (4,796)
Proceeds from Sale of CCRC Venture, net |  |
Supplemental Cash Flow Information [Abstract] |  |
Investment in unconsolidated ventures | (14,848) | 0
Current portion of long-term debt | 34,706 | 0
Accrued expenses | (5,025) | 0
Other liabilities | (60,748) | 0
Loss (gain) on sale of assets, net | (370,745) | 0
Net cash received | (295,164) | 0
Proceeds from sale of assets, net |  |
Supplemental Cash Flow Information [Abstract] |  |
Other liabilities | (824) | 78
Loss (gain) on sale of assets, net | (2,094) | 702
Prepaid expenses and other assets, net | (1,261) | (231)
Assets held for sale | (5,274) | (29,550)
Property, plant and equipment and leasehold intangibles, net | 0 | (457)
Net cash received | (9,453) | (29,458)
Purchase of Treasury Stock |  |
Supplemental Cash Flow Information [Abstract] |  |
Treasury stock | 0 | 288
Accounts payable | 0 | (288)
Net | 0 | 0
Assets designated as held for sale |  |
Supplemental Cash Flow Information [Abstract] |  |
Assets held for sale | 0 | 5,249
Net | 0 | 0
Property, plant and equipment and leasehold intangibles, net | 0 | 5,249
Healthpeak master lease modification |  |
Supplemental Cash Flow Information [Abstract] |  |
Operating lease right-of-use assets | 88,044 | 0
Financing lease obligations | 70,874 | 0
Operating lease obligations | (101,456) | 0
Net | 0 | 0
Property, plant and equipment and leasehold intangibles, net | (57,462) | 0
Noncash lease termination and modification, net |  |
Supplemental Cash Flow Information [Abstract] |  |
Financing lease obligations | 9,516 | 0
Other liabilities | (75) | (224)
Prepaid expenses and other assets, net | 0 | 160
Property, plant and equipment and leasehold intangibles, net | 9,441 | (175)
Net | 0 | 0
Loss (gain) on facility lease termination and modification, net | 0 | 209
Non-development | Additions to property, plant and equipment and leasehold improvements |  |
Supplemental Cash Flow Information [Abstract] |  |
Net cash paid | 60,556 | 54,602
Development | Additions to property, plant and equipment and leasehold improvements |  |
Supplemental Cash Flow Information [Abstract] |  |
Net cash paid | 3,900 | 5,269
Non-development - reimbursable | Additions to property, plant and equipment and leasehold improvements |  |
Supplemental Cash Flow Information [Abstract] |  |
Net cash paid | $ 5,827 | $ 0

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