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Summary of Significant Accounting Policies - Additional Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Jan. 01, 2019
Dec. 31, 2018
Dec. 31, 2017
Revenue Recognition          
Term of residency agreements - minimum 30 days        
Term of residency agreements - maximum 1 year        
Stock-Based Compensation          
Award vesting period 3 years        
Weighted average volatility rate 42.50% 45.20%      
Risk free interest rate 1.40% 2.40%      
Accounting Standards Update and Change in Accounting Principle          
Operating lease liabilities $ 965,655        
Operating lease right-of-use assets 788,138 $ 1,159,738      
Cumulative effect of change in accounting principle 802,729 698,725   $ 1,018,413 $ 1,530,291
Deferred tax position 9,557 15,397      
Change in valuation allowance 380,990 408,903      
Accumulated Deficit          
Accounting Standards Update and Change in Accounting Principle          
Cumulative effect of change in accounting principle $ (3,311,184) (3,393,088)   (3,069,272) (2,541,294)
Cumulative Effect, Period of Adoption, Adjustment | Accumulated Deficit          
Accounting Standards Update and Change in Accounting Principle          
Cumulative effect of change in accounting principle   (115)   (55,885) $ 0
ASU 2016-02          
Accounting Standards Update and Change in Accounting Principle          
Operating lease liabilities     $ 1,618,000 231,400  
Operating lease right-of-use assets     1,329,000    
Cumulative effect of change in accounting principle     (56,000)    
Right of use assets impairment loss   $ 10,200      
Deferred tax position       300  
Deferred tax assets       14,100  
Change in valuation allowance       $ 13,800  
ASU 2016-02 | Cumulative Effect, Period of Adoption, Adjustment | Accumulated Deficit          
Accounting Standards Update and Change in Accounting Principle          
Cumulative effect of change in accounting principle     $ 58,100    
Minimum          
Stock-Based Compensation          
Award vesting period 3 years        
Award vesting rights percentage 0.00%        
Fair value vesting rights, percentage 0.00%        
Maximum          
Stock-Based Compensation          
Award vesting period 4 years        
Award vesting rights percentage 125.00%        
Fair value vesting rights, percentage 150.00%