Property, Plant and Equipment and Leasehold Intangibles, Net (Details) (USD $) In Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010	Sep. 30, 2011	Sep. 30, 2010	Dec. 31, 2010
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles, gross	$ 5,032,885		$ 5,032,885		$ 4,914,760
Accumulated depreciation and amortization	(1,351,605)		(1,351,605)		(1,177,918)
Property, plant and equipment and leasehold intangibles, net	3,681,280		3,681,280		3,736,842
Asset impairment, non-cash charge	0	0	14,846	0
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles, gross	272,865		272,865		273,214
Building and Building Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles, gross	3,035,239		3,035,239		3,003,788
Furniture and Equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles, gross	429,966		429,966		382,488
Resident and Leasehold Operating Intangibles [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles, gross	592,593		592,593		588,633
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles, gross	44,545		44,545		16,463
Assets Held under Capital and Financing Leases [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment and leasehold intangibles, gross	$ 657,677		$ 657,677		$ 650,174