Derivative Instruments (Details 1) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015		Sep. 30, 2014
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ (49,000)	$ 58,427,000	[1]	$ (400,000)
Interest Rate Swap [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	0	(4,000)	(1,000)		(11,000)
Gain (loss) on interest rate swaps recalssified from AOCI into income (effective portion)	(462,000)	(459,000)	(1,390,000)		(1,338,000)
Gain (loss) on forward exchange contracts recognized in income.	2,347,000	0	6,285,000		0
Foreign Exchange Contract [Member]
Derivative [Line Items]
Gain (loss) recognized in OCI	174,239,000	12,880,000	208,854,000		6,833,000
Derivative Gain Loss On Derivative Net	0	(49,000)	0		(400,000)
Gain on Release of cumulative translation adjustment related to net investment hedge of an equity investment	0	528,000	0		528,000
Foreign Exchange Option Member
Derivative [Line Items]
Derivative Gain Loss On Derivative Net	$ 0	$ 0	$ (58,427,000)		$ 0

[1] (1) In April 2011, we completed the acquisition of substantially all of the real estate assets of privately-owned Genesis Healthcare Corporation. In conjunction with this transaction, we received the option to acquire an ownership interest in Genesis Healthcare. In February 2015, Genesis Healthcare closed on a transaction to merge with Skilled Healthcare Group to become a publicly traded company which required us to record the value of the derivative asset due to the net settlement feature.