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Acquisitions Business Acquisition Narrative (Details) $ in Thousands |  |  |  |  |  | 3 Months Ended | 9 Months Ended | 12 Months Ended |  |  |
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Jan. 20, 2016 USD ($) unit | Jul. 01, 2015 USD ($) shares | Mar. 30, 2015 USD ($) unit | Feb. 09, 2015 USD ($) unit | Jan. 01, 2015 USD ($) Rate | Jun. 30, 2016 USD ($) | Mar. 31, 2016 USD ($) | Dec. 31, 2015 USD ($) | Dec. 31, 2014 USD ($) | Sep. 30, 2016 USD ($) unit | Sep. 30, 2015 USD ($) | Dec. 31, 2015 USD ($) | Aug. 01, 2016 USD ($) unit | Apr. 13, 2016 USD ($) unit | Mar. 01, 2016 USD ($) unit
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners |  |  |  |  |  |  |  | 19.00% |  |  |  | 19.00% |  |  |
Mortgage borrowing |  |  |  |  |  |  |  | $ 673,632 |  | $ 782,407 |  | $ 673,632 |  |  |
Number of Real Estate Properties | unit | 1 |  |  |  |  |  |  |  |  |  |  |  | 1 | 5 | 1
2016 Acquisitions |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Fair value of total consideration |  |  |  |  |  |  |  | 125 |  | 84,605 |  |  |  |  |
Payments to Acquire Businesses, Gross | $ 4,778 |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual |  |  |  |  |  |  |  |  |  | 7,247 |  |  |  |  |
Business Combination, Pro Forma Information, Earnings or Loss of Acquiree since Acquisition Date, Actual |  |  |  |  |  |  |  |  |  | $ (1,899) |  |  |  |  |
Number of Real Estate Properties | unit |  |  |  |  |  |  |  |  |  | 3 |  |  |  |  |
Real estate acquired, purchase accounting adjustment |  |  |  |  |  | $ 540 |  |  |  |  |  |  |  |  |
Depreciation adjustment, purchase accounting adjustment |  |  |  |  |  | (213) | $ (80) |  |  |  |  |  |  |  |
Intangible Assets, Purchase Accounting Adjustments |  |  |  |  |  | $ (540) |  |  |  |  |  |  |  |  |
Reliance |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Fair value of total consideration |  | $ 24,441 |  |  |  |  |  |  |  |  |  |  |  |  |
Payments to Acquire Businesses, Gross |  | $ 10,281 |  |  |  |  |  |  |  |  |  |  |  |  |
Percentage of voting interest |  | 100.00% |  |  |  |  |  |  |  |  |  |  |  |  |
Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual |  |  |  |  |  |  |  |  |  |  | $ 11,252 |  |  |  |
Business Combination, Pro Forma Information, Earnings or Loss of Acquiree since Acquisition Date, Actual |  |  |  |  |  |  |  |  |  |  | 551 |  |  |  |
Greenfield Holdings, LLC 3/30/2015 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Fair value of total consideration |  |  | $ 54,536 |  |  |  |  |  | $ 1,490 |  |  |  |  |  |
Number of Real Estate Properties | unit |  |  | 6 |  |  |  |  |  |  |  |  |  |  |  |
2015 Acquisitions |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Fair value of total consideration |  |  |  |  |  |  |  |  |  |  | 108,228 |  |  |  |
Payments to Acquire Businesses, Gross |  |  |  |  |  |  |  |  |  |  | 94,068 |  |  |  |
Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual |  |  |  |  |  |  |  |  |  |  | 8,378 |  |  |  |
Business Combination, Pro Forma Information, Earnings or Loss of Acquiree since Acquisition Date, Actual |  |  |  |  |  |  |  |  |  |  | (2,577) |  |  |  |
Business Acquisition, Equity Interest Issued or Issuable, Value Assigned |  |  |  |  |  |  |  |  |  |  | 11,960 |  |  |  |
Business Combination, Contingent Consideration, Liability |  |  |  |  |  |  |  |  |  |  | $ 2,200 |  |  |  |
Royal Senior Care Management |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Fair value of total consideration |  |  |  | $ 29,251 |  |  |  |  | $ 587 |  |  |  |  |  |
Payments to Acquire Businesses, Gross |  |  |  | $ 1,861 |  |  |  |  |  |  |  |  |  |  |
Number of Real Estate Properties | unit |  |  |  | 5 |  |  |  |  |  |  |  |  |  |  |
Mortgages |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Mortgage borrowing | $ 28,000 |  |  |  |  |  |  | $ 76,818 |  | $ 76,744 |  | 76,818 | $ 20,600 | $ 22,500 | $ 11,218
Mortgages | 2016 Acquisitions |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Mortgage borrowing |  |  |  |  |  |  |  |  |  | $ 59,817 |  |  |  |  |
Mortgages | Greenfield Holdings, LLC 3/30/2015 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Mortgage borrowing |  |  | $ 39,500 |  |  |  |  |  |  |  |  |  |  |  |
Mortgages | Royal Senior Care Management |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Mortgage borrowing |  |  |  | $ 19,943 |  |  |  |  |  |  |  |  |  |  |
ProtectCell | Noncontrolling interest |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners | Rate |  |  |  |  | 37.60% |  |  |  |  |  |  |  |  |  |
Payments to Acquire Additional Interest in Subsidiaries |  |  |  |  | $ 3,000 |  |  |  |  |  |  | $ 4,100 |  |  |
Common Stock - Class A | Reliance |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition, Equity Interest Issued or Issuable, Number of Shares | shares |  | 1,625,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition, Equity Interest Issued or Issuable, Value Assigned |  | $ 11,960 |  |  |  |  |  |  |  |  |  |  |  |  |
Business Combination, Contingent Consideration, Liability |  | $ 2,200 |  |  |  |  |  |  |  |  |  |  |  |  |

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