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Property, Plant and Equipment and Leasehold Intangibles, Net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 8,542,662		$ 8,542,662		$ 8,346,845
Accumulated depreciation and amortization	(3,415,495)		(3,415,495)		(3,237,011)
Property, plant and equipment and leasehold intangibles, net	5,127,167		5,127,167		5,109,834
Finance lease, right-of-use asset	400,000		400,000		600,000
Depreciation and amortization expense	87,800	$ 93,300	271,700	$ 282,600
Land
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	503,686		503,686		450,894
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	5,193,677		5,193,677		4,790,769
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	933,474		933,474		859,849
Resident and leasehold operating intangibles
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	310,230		310,230		317,111
Construction in progress
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	62,319		62,319		80,729
Assets under financing leases and leasehold improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles	$ 1,539,276		$ 1,539,276		$ 1,847,493

X

- 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

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Amount, after accumulated amortization, of right-of-use asset from finance lease.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 842
-SubTopic 20
-Section 45
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-Subparagraph (a)
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Amount of accumulated depreciation and amortization from plant, property, and equipment and right-of-use asset from finance lease.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
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-Paragraph 1
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Amount, after accumulated depreciation and amortization, of property, plant, and equipment and finance lease right-of-use asset.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=6391035&loc=d3e2868-110229

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+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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