Leases Balance Sheet Impact on New Lease Guidance (Details) - USD ($) $ in Thousands		3 Months Ended
	Jan. 01, 2019	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017
Operating Leased Assets [Line Items]
Assets		$ 2,218,359		$ 1,181,958
Liabilities		1,573,356		579,618
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest		645,003	$ 525,943	602,340	$ 500,059
Liabilities, Current		311,443		$ 269,227
Net income attributable to The Ensign Group, Inc.		27,372	$ 23,132
Difference between Lease Guidance in Effect before and after Topic 842 [Member]
Operating Leased Assets [Line Items]
Assets		1,003,849
Liabilities		994,935
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest		8,914
Net income attributable to The Ensign Group, Inc.		116
Calculated under Lease Guidance in Effect before Topic 842 [Member]
Operating Leased Assets [Line Items]
Assets		1,214,510
Liabilities		578,421
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest		636,089
Liabilities, Current		254,087
Net income attributable to The Ensign Group, Inc.		$ 27,256
Accounting Standards Update 2016-02 [Member]
Operating Leased Assets [Line Items]
Cumulative Effect on Retained Earnings, Net of Tax	$ 9,030