Genesis Healthcare (GENN) 10-Q 8 May 15 2015 Q1 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	3 Months Ended
	Mar. 31, 2015	7-May-15
Document and Entity Information [Line Items]
Entity Registrant Name	Genesis Healthcare, Inc.
Entity Central Index Key	1351051
Current Fiscal Year End Date	-19
Entity Filer Category	Accelerated Filer
Document Type	10-Q
Document Period End Date	31-Mar-15
Document Fiscal Year Focus	2015
Document Fiscal Period Focus	Q1
Amendment Flag	FALSE
Class A Common Stock
Document and Entity Information [Line Items]
Entity Common Stock, Shares Outstanding		73,591,665
Class B Common Stock
Document and Entity Information [Line Items]
Entity Common Stock, Shares Outstanding		15,511,603
Class C Common Stock
Document and Entity Information [Line Items]
Entity Common Stock, Shares Outstanding		64,449,380

Consolidated_Balance_Sheets_Un

Consolidated Balance Sheets (Unaudited) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$95,708	$87,548
Restricted cash and investments in marketable securities	52,234	38,211
Accounts receivable, net of allowance for doubtful accounts of $139,389 and $133,529 at March 31, 2015 and December 31, 2014	763,006	605,830
Prepaid expenses	49,112	72,873
Other current assets	38,453	33,511
Deferred income taxes	2,443	58,213
Total current assets	1,000,956	896,186
Property and equipment, net of accumulated depreciation of $555,828 and $502,176 at March 31, 2015 and December 31, 2014	3,947,941	3,493,250
Restricted cash and investments in marketable securities	120,547	108,529
Other long-term assets	163,326	140,119
Deferred income taxes	142,018	160,531
Identifiable intangible assets, less accumulated amortization of $48,507 and $42,661 at March 31, 2015 and December 31, 2014	233,181	173,112
Goodwill	423,387	169,681
Total assets	6,031,356	5,141,408
Current liabilities:
Current installments of long-term debt	12,746	12,518
Less current portion	3,004	2,875
Financing obligations	1,098	1,138
Accounts payable	218,565	194,508
Accrued expenses	155,484	125,831
Accrued compensation	255,881	192,838
Self-insurance reserves	144,897	130,874
Total current liabilities	791,675	660,582
Long-term liabilities:
Long-term debt	980,911	525,728
Long-term capital lease obligation	1,005,555	1,002,762
Financing obligations	2,928,998	2,911,200
Deferred income taxes		19,215
Self-insurance reserves	400,309	355,344
Other long-term liabilities	129,428	124,067
Commitments and contingencies
Stockholders' equity:
Additional paid-in-capital	298,369	143,492
Accumulated deficit	-417,974	-603,254
Accumulated other comprehensive income	631	515
Total stockholders' deficit before noncontrolling interests	-118,820	-459,197
Noncontrolling interests	-86,700	1,707
Total stockholders' deficit	-205,520	-457,490
Total liabilities and stockholders' deficit	6,031,356	5,141,408
Class A Common Stock
Stockholders' equity:
Common stock	74	50
Class B Common Stock
Stockholders' equity:
Common stock	16
Class C Common Stock
Stockholders' equity:
Common stock	$64

Consolidated_Balance_Sheets_Un1

Consolidated Balance Sheets (Unaudited) (Parentheticals) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, except Share data, unless otherwise specified
Current assets:
Allowance for doubtful accounts	$139,389	$133,529
Other assets:
Accumulated depreciation on property and equipment	555,828	502,176
Accumulated amortization on intangible assets	$48,507	$42,661
Class A Common Stock
Stockholders' equity:
Common stock, par value (usd per share)	$0.00	$0.00
Common stock, shares authorized (in shares)	175,000,000	175,000,000
Common stock, shares, issued (in shares)	73,587,665	49,864,878
Common stock, shares, outstanding (in shares)	73,587,665	49,864,878
Class B Common Stock
Stockholders' equity:
Common stock, par value (usd per share)	$0.00	$0.00
Common stock, shares authorized (in shares)	30,000,000	30,000,000
Common stock, shares, issued (in shares)	15,511,603	0
Common stock, shares, outstanding (in shares)	15,511,603	0
Class C Common Stock
Stockholders' equity:
Common stock, par value (usd per share)	$0.00	$0.00
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares, issued (in shares)	64,449,380	0
Common stock, shares, outstanding (in shares)	64,449,380	0

Consolidated_Statements_of_Ope

Consolidated Statements of Operations (Unaudited) (USD $)	3 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED)
Net revenues	$1,343,001	$1,186,544
Salaries, wages and benefits	819,938	746,490
Other operating expenses	348,285	292,698
Lease expense	36,419	32,799
Depreciation and amortization expense	59,933	47,500
Interest expense	121,313	108,750
Loss on early extinguishment of debt	3,234	499
Investment income	-416	-943
Other income	-7,611
Transaction costs	86,069	2,249
Equity in net (income) loss of unconsolidated affiliates	-153	44
Loss before income tax benefit	-124,010	-43,542
Income tax benefit	-5,648	-2,754
Loss from continuing operations	-118,362	-40,788
Income (loss) from discontinued operations, net of taxes	112	-3,194
Net loss	-118,250	-43,982
Less net loss (income) attributable to noncontrolling interests	5,684	-185
Net loss attributable to Genesis Healthcare, Inc	($112,566)	($44,167)
Denominator:
Weighted-average shares outstanding for basic and diluted net loss per share	75,234	49,865
Loss from continuing operations attributable to Genesis Healthcare, Inc.	($1.50)	($0.82)
Income (loss) from discontinued operations		($0.06)
Net loss attributable to Genesis Healthcare, Inc.	($1.50)	($0.88)

Consolidated_Statements_of_Com

Consolidated Statements of Comprehensive Income (Loss) (Unaudited) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (UNAUDITED)
Net loss attributable to Genesis Healthcare, Inc	($112,566)	($44,167)
Net unrealized gain on marketable securities, net of tax	270	132
Comprehensive loss	-112,296	-44,035
Comprehensive (loss) income attributable to noncontrolling interests	-5,382	185
Comprehensive loss attributable to Genesis Healthcare, Inc.	($117,678)	($43,850)

Consolidated_Statements_of_Sto

Consolidated Statements of Stockholders' Equity (Deficit) (Unaudited) (USD $)	Stockholders' deficit	Common Stock	Common Stock	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)	Noncontrolling interests	Total
In Thousands, unless otherwise specified		Class A Common Stock	Class B Common Stock	Class C Common Stock
Balance, beginning of period at Dec. 31, 2013	($186,699)	$50			$161,452	($349,269)	$1,068	$2,818	($183,881)
Balance, beginning of period (in shares) at Dec. 31, 2013		49,865
Comprehensive (loss) income:
Net loss						-253,985
Net unrealized loss on marketable securities, net of tax							-553
Total comprehensive loss	-254,538							2,456	-252,082
Distributions to stockholders	-17,960				-17,960				-17,960
Distributions to noncontrolling interests								-3,567	-3,567
Balance, end of period at Dec. 31, 2014	-459,197	50			143,492	-603,254	515	1,707	-457,490
Balance, beginning of period (in shares) at Dec. 31, 2014		49,865
Comprehensive (loss) income:
Combination share conversion	428,326	24	16	64	130,530	297,846	-154	-80,186	348,140
Combination share conversion (in shares)		23,723	15,512	64,449
Net loss						-112,566			-112,566
Net unrealized loss on marketable securities, net of tax							270
Total comprehensive loss	-112,296							-5,382	-117,678
Stock-based compensation	-24,347				-24,347				-24,347
Distributions to noncontrolling interests								-2,839	-2,839
Balance, end of period at Mar. 31, 2015	($118,820)	$74	$16	$64	$298,369	($417,974)	$631	($86,700)	($205,520)
Balance, end of period (in shares) at Mar. 31, 2015		73,588	15,512	64,449

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
Cash Flows from Operating Activities
Net loss	($118,250)	($43,982)
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Non-cash interest and leasing arrangements, net	23,413	22,456
Other non-cash charges and gains, net	-7,587	3,178
Non-cash stock-based compensation	25,373
Depreciation and amortization	60,077	49,151
Provision for losses on accounts receivable	23,392	18,870
Equity in net (income) loss of unconsolidated affiliates	-153	44
Provision for deferred taxes	-9,493	-8,733
Changes in operating assets and liabilities:
Accounts receivable	-43,860	-17,559
Accounts payable and other accrued expenses and other	44,606	-10,607
Total adjustments	115,768	56,800
Net cash (used in) provided by operating activities	-2,482	12,818
Cash Flows from Investing Activities
Capital expenditures	-16,721	-23,573
Purchases of marketable securities	-15,319	-7,728
Proceeds on maturity or sale of marketable securities	10,158	9,718
Net change in restricted cash and equivalents	-361	-7,034
Sale of investment in joint venture	26,358
Sales of assets	1,263
Other, net	912	12
Net cash provided by (used in) investing activities	6,290	-28,605
Cash Flows from Financing Activities
Borrowings under revolving credit facility	146,500	139,000
Repayments under revolving credit facility	-151,000	-112,000
Proceeds from issuance of long-term debt	360,000
Proceeds from tenant improvement draws under lease arrangements	95	1,290
Repayments of long-term debt	-330,627	-3,255
Debt issuance costs	-17,777	-3,853
Distributions to noncontrolling interests	-2,839	-7,572
Net cash provided by financing activities	4,352	13,610
Net increase (decrease) in cash and cash equivalents	8,160	-2,177
Beginning of period	87,548	61,413
End of period	95,708	59,236
Supplemental disclosure of cash flow information
Interest paid	94,948	92,915
Taxes paid	5,917	2,695
Non-cash financing activities:
Capital leases		13,096
Financing obligations	3,682	38,865
Assumptions of long-term debt	$326,610

General_Information

General Information	3 Months Ended
	Mar. 31, 2015
General Information
Description of Business	(1)General Information
	Description of Business
	Genesis Healthcare, Inc. is a healthcare services company that through its subsidiaries (collectively, the Company) owns and operates skilled nursing facilities, assisted living facilities, hospices, home health providers and a rehabilitation therapy business.  The Company has an administrative service company that provides a full complement of administrative and consultative services that allows our affiliated operators and third-party operators with whom the Company contracts to better focus on delivery of healthcare services. The Company provides inpatient services through 511 skilled nursing, assisted living and behavioral health centers located in 34 states.  Revenues of the Company’s owned, leased and otherwise consolidated centers constitute approximately 85% of its revenues.
	The Company provides a range of rehabilitation therapy services, including speech pathology, physical therapy, occupational therapy and respiratory therapy.  These services are provided by rehabilitation therapists and assistants employed or contracted at substantially all of the centers operated by the Company, as well as by contract to healthcare facilities operated by others.  After the elimination of intercompany revenues, the rehabilitation therapy services business constitutes approximately 12% of the Company’s revenues.
	The Company provides an array of other specialty medical services, including management services, physician services, staffing services, hospice and home health services, and other healthcare related services, which comprise the balance of the Company’s revenues.
	Basis of Presentation
	The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles.  In the opinion of management, the consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented.
	The accompanying unaudited consolidated financial statements have been prepared in accordance with the instructions for Form 10-Q of Regulation S-X and do not include all of the disclosures normally required by generally accepted accounting principles or those normally required in annual reports on Form 10-K. Accordingly, these financial statements should be read in conjunction with the audited consolidated financial statements of the Company for the year ended December 31, 2014 filed with the Securities and Exchange Commission on Form 8-K/A on February 26, 2015. The accompanying consolidated balance sheet at December 31, 2014 was derived from audited consolidated financial statements, but does not include all disclosures required by generally accepted accounting principles.
	Certain prior year amounts have been reclassified to conform to current period presentation, the effect of which was not material.  The Company’s membership interest at December 31, 2014 has been recast as common stock and additional paid-in capital.
	The Company’s financial position at March 31, 2015 includes the impact of the Combination (as defined in Note 3 —  “Significant Transactions and Events — The Combination with Skilled”), which has been accounted for as a reverse acquisition using the acquisition method effective February 2, 2015.
	Recent Accounting Pronouncements
	In May 2014, the Financial Accounting Standards Board (the FASB) issued ASU No. 2014-09, Revenue from Contracts with Customers, (ASU 2014-09) which changes the requirements for recognizing revenue when entities enter into contracts with customers. Under ASU 2014-09, an entity will recognize revenue when it transfers promised goods or services to customers in an amount that reflects what it expects in exchange for the goods or services. It also requires more detailed disclosures to enable users of financial statements to understand the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The adoption of ASU 2014-09 is effective for annual and interim periods beginning after December 15, 2017 and early adoption is not permitted. The Company is still evaluating the effect, if any, ASU 2014-09 will have on the Company’s consolidated financial condition and results of operations.
	In April 2015, the FASB issued ASU No. 2015-03, Simplifying the Presentation of Debt Issuance Costs, (ASU 2015-03). This ASU requires an entity to present debt issuance costs as a direct deduction from the carrying amount of the related debt liability, consistent with debt discounts.  The costs will continue to be amortized to interest expense using the effective interest method. The adoption of ASU 2015-03 is effective for fiscal years beginning after December 15, 2015, and interim periods within those fiscal years, with early adoption permitted. This ASU requires retrospective application to all prior periods presented in the financial statements.  The adoption of ASU No. 2015-03 is not expected to have a material impact on the Company’s consolidated financial condition and results of operations.

Certain_Significant_Risks_and_

Certain Significant Risks and Uncertainties	3 Months Ended
	Mar. 31, 2015
Certain Significant Risks and Uncertainties
Certain Significant Risks and Uncertainties	(2)Certain Significant Risks and Uncertainties
	Revenue Sources
	The Company receives revenues from Medicare, Medicaid, private insurance, self-pay residents, other third-party payors and long-term care facilities that utilize its rehabilitation therapy and other services.  The Company’s inpatient services segment derives approximately 79% of its revenue from Medicare and various state Medicaid programs.
	The sources and amounts of the Company’s revenues are determined by a number of factors, including licensed bed capacity and occupancy rates of its inpatient facilities, the mix of patients and the rates of reimbursement among payors.  Likewise, payment for ancillary medical services, including services provided by the Company’s rehabilitation therapy services business, varies based upon the type of payor and payment methodologies.  Changes in the case mix of the patients as well as payor mix among Medicare, Medicaid and private pay can significantly affect the Company’s profitability.
	It is not possible to quantify fully the effect of legislative changes, the interpretation or administration of such legislation or other governmental initiatives on the Company’s business and the business of the customers served by the Company’s rehabilitation therapy business.  The potential impact of reforms to the United States healthcare system, including potential material changes to the delivery of healthcare services and the reimbursement paid for such services by the government or other third party payors, is uncertain at this time.  Accordingly, there can be no assurance that the impact of any future healthcare legislation or regulation will not adversely affect the Company’s business.  There can be no assurance that payments under governmental and private third-party payor programs will be timely, will remain at levels similar to present levels or will, in the future, be sufficient to cover the costs allocable to patients eligible for reimbursement pursuant to such programs.  The Company’s financial condition and results of operations are and will continue to be affected by the reimbursement process, which in the healthcare industry is complex and can involve lengthy delays between the time that revenue is recognized and the time that reimbursement amounts are settled.
	Laws and regulations governing the Medicare and Medicaid programs, and our business generally, are complex and are often subject to a number of ambiguities in their application and interpretation. The Company believes that it is in substantial compliance with all applicable laws and regulations.  However, from time to time the Company and its affiliates are subject to pending or threatened lawsuits and investigations involving allegations of potential wrongdoing, some of which may be material or involve significant costs to resolve and/or defend against, or may lead to other adverse effects on the Company and its affiliates including, but not limited to, fines, penalties and exclusion from participation in the Medicare and/or Medicaid programs.  Our business is subject to a number of other known and unknown risks and uncertainties, which are discussed in Item 1A (Risk Factors) of our Annual Report on Form 10-K for the fiscal year ended December 31, 2014, which was filed with the Securities and Exchange Commission on February 20, 2015.

Significant_Transactions_and_E

Significant Transactions and Events	3 Months Ended
	Mar. 31, 2015
Significant Transactions and Events
Significant Transactions and Events	(3)Significant Transactions and Events
	The Combination with Skilled
	On August 18, 2014, Skilled Healthcare Group, Inc., a Delaware corporation (Skilled) entered into a Purchase and Contribution Agreement with FC-GEN Operations Investment, LLC (FC-GEN) pursuant to which the businesses and operations of FC-GEN and Skilled were combined (the Combination). On February 2, 2015, the Combination was completed.
	The following diagram depicts the organizational structure of the Company at the time of the Combination:
	Upon completion of the Combination, the Company began operating under the name Genesis Healthcare, Inc. and the Class A common stock of the combined company continues to trade on the NYSE under the symbol “GEN”.  Upon the closing of the Combination, the former owners of FC-GEN held 74.25% of the economic interests in the combined entity and the former shareholders of Skilled held the remaining 25.75% of the economic interests in the combined entity post-transaction, in each case on a fully-diluted, as-exchanged and as-converted basis.  Under applicable accounting standards, FC-GEN was the accounting acquirer in the Combination, which was treated as a reverse acquisition. The acquisition method has been applied to the Combination based on Skilled’s stock price (level 1 valuation technique - quoted prices in active markets for identical assets or liabilities) as of the acquisition date. The consideration has been allocated to the legacy Skilled business that was acquired on the acquisition date with the excess consideration over the fair value of the net assets acquired recognized as goodwill. As of the effective date of the Combination, FC-GEN’s assets and liabilities remained at their historical costs.
	Because FC-GEN’s pre-transaction owners held an approximately 58% direct controlling interest in Skilled and a 74.25% economic and voting interest in the combined company, FC-GEN is considered to be the acquirer of Skilled for accounting purposes. Following the closing of the Combination, the combined results of Skilled and FC-GEN are consolidated with approximately 42% direct noncontrolling economic interest shown as noncontrolling interest in the financial statements of the combined entity. The 42% direct noncontrolling economic interest is in the form of membership units that are exchangeable on a 1 to 1 basis to public shares of the Company. The 42% direct noncontrolling economic interest will continue to decrease as membership units are converted to public shares of the Company.
	Consideration Price Allocation
	The total Skilled consideration price of $348.1 million was allocated to Skilled’s net tangible and identifiable intangible assets based upon the estimated fair values at February 2, 2015.  The excess of the consideration price over the estimated fair value of the net tangible and identifiable intangible assets was recorded as goodwill.  The allocation of the consideration price to property, plant and equipment, identifiable intangible assets and deferred income taxes was based upon valuation data and estimates.  The Company has not finalized the analysis of the consideration price allocation and will continue its review during the measurement period.  The aggregate goodwill arising from the Combination is based upon the expected future cash flows of the Skilled operations.  Goodwill recognized from the Combination is the result of (i) the expected savings to be realized from achieving certain economies of scale and (ii) anticipated long-term improvements in Skilled’s core businesses.  The Company has estimated $79.8 million of pre-existing Skilled goodwill that is deductible for income tax purposes related to the Combination.
	The consideration price and related allocation are summarized as follows (in thousands):
	Accounts receivable	$	128,782
	Deferred income taxes and other current assets	42,533
	Property, plant and equipment	495,692
					Weighted
					Average Life
					(Years)
	Identifiable intangible assets:
	Management contracts	30,900			3.5
	Customer relationships	13,400			10
	Favorable lease contracts	18,220			12.8
	Trade names	3,400			Indefinite
	Total identifiable intangible assets	65,920
	Deferred income taxes and other assets	59,196
	Accounts payable and other current liabilities	(115,292		)
	Long-term debt, including amounts due within one year	(428,342		)
	Unfavorable lease contracts	(11,480		)
	Deferred income taxes and other long-term liabilities	(142,574		)
	Total identifiable net assets	94,435
	Goodwill	253,705
	Net assets	$	348,140
	Pro forma information
	The acquired business contributed net revenues of $152.7 million and a net income of $5.3 million, to the Company for the period from February 1, 2015 to March 31, 2015. The unaudited pro forma net effect of the Combination assuming the acquisition occurred as of January 1, 2014 is as follows (in thousands, except per share amounts):
		Pro Forma Three months ended March 31,
		2015			2014
	Revenues	$	1,414,289		$	1,393,844
	Loss attributable to Genesis Healthcare, Inc.	(16,317		)	(17,568		)
	Loss per share from continuing operations attributable to Genesis Healthcare, Inc.
	Basic	(0.18		)	(0.16		)
	Diluted	(0.19		)	(0.22		)
	The unaudited pro forma financial data have been derived by combining the historical financial results of the Company and the operations acquired in the Combination for the periods presented. The unaudited pro forma financial data includes transaction and financing costs totaling $84.7 million incurred by both the Company and Skilled in connection with the Combination. These costs have been eliminated from the results of operations for the three months ended March 31, 2015 for purposes of the pro forma financial presentation.
	Related Party Transactions
	On March 31, 2015, the Company sold its investment in FC PAC Holdings, LLC (FC PAC), an unconsolidated joint venture in which it held an approximate 5.4% interest, for $26.4 million. The Company recognized a gain on sale of $8.4 million recorded as other income on the statement of operations. FC PAC ownership includes affiliates of Formation Capital, a private equity sponsor of the Company prior to the Combination, and also represented by members of the Company’s board of directors.

Earnings_Loss_Per_Share

Earnings (Loss) Per Share	3 Months Ended
	Mar. 31, 2015
Earnings (Loss) Per Share
Earnings (Loss) Per Share	(4)Earnings (Loss) Per Share
	The Company has three classes of common stock.  Classes A and B are identical in economic and voting interests.  Class C has a 1:1 voting ratio with the other two classes, representing the voting interests of the approximate 42% noncontrolling interest of the legacy FC-GEN owners.  See Note 3 — “Significant Transactions and Events — the Combination with Skilled”.   Class C common stock is a participating security; however, it shares in a de minimis economic interest and is therefore excluded from the denominator of the basic earnings per share calculation.
	Basic net loss per share was computed by dividing net loss by the weighted-average number of outstanding common shares for the period. Diluted earnings per share is computed by dividing loss plus the effect of assumed conversions (if applicable) by the weighted-average number of outstanding shares after giving effect to all potential dilutive common stock, including options, warrants, common stock subject to repurchase and convertible preferred stock, if any.
	The computations of basic and diluted loss per share are consistent with any potentially dilutive adjustments to the numerator or denominator being anti-dilutive and therefore excluded from the dilutive calculation.  A reconciliation of the numerator and denominator used in the calculation of basic and diluted net income per common share follows (in thousands, except per share data):
		Three Months Ended March 31,
		2015			2014
	Numerator:
	Loss from continuing operations	$	(118,362	)	$	(40,788	)
	Less: Net (loss) income attributable to noncontrolling interests	(5,684		)	185
	Loss from continuing operations attributable to Genesis Healthcare, Inc.	(112,678		)	(40,973		)
	Income (loss) from discontinued operations, net of income tax	112			(3,194		)
	Net loss attributable to Genesis Healthcare, Inc.	$	(112,566	)	$	(44,167	)
	Denominator:
	Weighted average shares outstanding for basic and diluted net loss per share	75,234			49,865
	Basic and diluted net loss per common share:
	Loss from continuing operations attributable to Genesis Healthcare, Inc.	$	(1.50	)	$	(0.82	)
	Income (loss) from discontinued operations	—			(0.06		)
	Net loss attributable to Genesis Healthcare, Inc.	$	(1.50	)	$	(0.88	)
	The following were excluded from net income attributed to Genesis Healthcare, Inc. and the weighted-average diluted shares computation for the three months ended March 31, 2015 and 2014, as their inclusion would have been anti-dilutive (shares in thousands):
		Three Months Ended March 31,
		2015					2014
		Net loss					Net loss
		attributed to					attributed to
		Genesis Healthcare,			Anti-dillutive		Genesis Healthcare,		Anti-dillutive
		Inc.			shares		Inc.		shares
	Exchange of restricted stock units of noncontrolling interests	$	(4,217	)	41,534		$	—	—
	Because the Company is in a net loss position for the three months ended March 31, 2015, the combined impact of the assumed conversion of the approximate 42% noncontrolling interest to common stock and the related tax implications, are anti-dilutive to EPS.  As of March 31, 2015 there were 64,449,380 units attributed to the noncontrolling interests outstanding.  See Note 3 — “Significant Transactions and Events — the Combination with Skilled.”   There were no convertible instruments issued or outstanding as of March 31, 2014 that could be potentially dilutive to net loss for that period.

Segment_Information

Segment Information	3 Months Ended
	Mar. 31, 2015
Segment Information
Segment Information	(5)    Segment Information
	The Company has three reportable operating segments: (i) inpatient services; (ii) rehabilitation therapy services; and (iii) other services. For additional information on these reportable segments see Note 1 — “General Information — Description of Business.”
	A summary of the Company’s unaudited condensed consolidated statement of operations follows:
		Three months ended March 31, 2015
		Inpatient			Rehabilitation		Other Services		Corporate			Eliminations			Consolidated
		Services			Therapy
					Services
		(In thousands)
	Net revenues	$	1,145,009		$	263,051	$	52,336	$	210		$	(117,605	)	$	1,343,001
	Salaries, wages and benefits	542,692			214,797		33,244		29,205			—			819,938
	Other operating expenses	419,306			19,226		15,074		12,283			(117,604		)	348,285
	Lease expense	35,528			41		459		391			—			36,419
	Depreciation and amortization expense	48,225			2,867		362		8,479			—			59,933
	Interest expense	103,654			1		10		17,771			(123		)	121,313
	Loss on extinguishment of debt	—			—		—		3,234			—			3,234
	Investment income	(358		)	—		—		(181		)	123			(416		)
	Other income				—		—		(7,611		)	—			(7,611		)
	Transaction costs	371			—		—		85,698			—			86,069
	Equity in net (income) loss of unconsolidated affiliates	(309		)	—		—		(220		)	376			(153		)
	(Loss) income before income tax benefit	(4,100		)	26,119		3,187		(148,839		)	(377		)	(124,010		)
	Income tax benefit	—			—		—		(5,648		)	—			(5,648		)
	(Loss) income from continuing operations	$	(4,100	)	$	26,119	$	3,187	$	(143,191	)	$	(377	)	$	(118,362	)
		Three months ended March 31, 2014
		Inpatient			Rehabilitation		Other Services		Corporate			Eliminations			Consolidated
		Services			Therapy
					Services
		(In thousands)
	Net revenues	$	1,000,217		$	255,324	$	35,814	$	137		$	(104,948	)	$	1,186,544
	Salaries, wages and benefits	491,072			206,149		24,039		25,230			—			746,490
	Other operating expenses	357,623			18,930		10,460		10,633			(104,948		)	292,698
	Lease expense	32,320			44		213		222			—			32,799
	Depreciation and amortization expense	40,220			2,787		250		4,243			—			47,500
	Interest expense	96,460			1		209		12,203			(123		)	108,750
	Loss on extinguishment of debt	—			—		—		499			—			499
	Investment income	(424		)	—		—		(642		)	123			(943		)
	Transaction costs	—			—		—		2,249			—			2,249
	Equity in net (income) loss of unconsolidated affiliates	(290		)	—		—		—			334			44
	(Loss) income before income tax benefit	(16,764		)	27,413		643		(54,500		)	(334		)	(43,542		)
	Income tax benefit	—			—		—		(2,754		)	—			(2,754		)
	(Loss) income from continuing operations	$	(16,764	)	$	27,413	$	643	$	(51,746	)	$	(334	)	$	(40,788	)
	The following table presents the segment assets as of March 31, 2015 compared to December 31, 2014 (in thousands):
		March 31, 2015			December 31, 2014
	Inpatient services	$	5,239,633		$	4,381,044
	Rehabilitation services	416,652			322,268
	Other services	93,216			44,814
	Corporate and eliminations	281,855			393,282
	Total assets	$	6,031,356		$	5,141,408

Property_and_Equipment

Property and Equipment	3 Months Ended
	Mar. 31, 2015
Property, Plant and Equipment [Abstract]
Property and Equipment	(6)Property and Equipment
	Property and equipment consisted of the following as of March 31, 2015 and December 31, 2014 (in thousands):
		March 31, 2015			December 31, 2014
	Land, buildings and improvements	$	594,970		$	225,536
	Capital lease land, buildings and improvements	913,814			910,820
	Financing obligation land, buildings and improvements	2,549,389			2,526,792
	Equipment, furniture and fixtures	411,446			276,983
	Construction in progress	34,150			55,295
	Gross property and equipment	4,503,769			3,995,426
	Less: accumulated depreciation	(555,828		)	(502,176		)
	Net property and equipment	$	3,947,941		$	3,493,250

LongTerm_Debt

Long-Term Debt	3 Months Ended
	Mar. 31, 2015
Long-Term Debt Abstract
Long-Term Debt	(7)Long-Term Debt
	Long-term debt at March 31, 2015 and December 31, 2014 consisted of the following (in thousands):
		March 31, 2015			December 31, 2014
	Revolving credit facility	$	250,000		$	254,500
	Term loan facility, net of original issue discount of $10,400 at March 31, 2015 and $11,375 at December 31, 2014	219,964			219,297
	Real estate bridge loan	360,000			—
	HUD insured loans	100,845			—
	Mortgages and other secured debt (recourse)	13,370			14,488
	Mortgages and other secured debt (non recourse)	49,478			49,961
		993,657			538,246
	Less:
	Current installments of long-term debt	(12,746		)	(12,518		)
	Long-term debt	$	980,911		$	525,728
	Revolving Credit Facilities
	In connection with the Combination, on February 2, 2015 the Company entered into new revolving credit facilities and terminated its former revolving credit facilities.  The new revolving credit facilities (the Revolving Credit Facilities) consist of a senior secured, asset-based revolving credit facility of up to $550 million under three separate tranches:  Tranche A-1, Tranche A-2 and FILO Tranche.  Interest accrues at a per annum rate equal to either (x) a base rate (calculated as the highest of the (i) prime rate, (ii) the federal funds rate plus 3.00%, or (iii) LIBOR plus the excess of the applicable margin between LIBOR loans and base rate loans) plus an applicable margin or (y) LIBOR plus an applicable margin.  The applicable margin is based on the level of commitments for all three tranches, and in regards to LIBOR loans (i) for Tranche A-1 ranges from 3.25% to 2.75%; (ii) for Tranche A-2 ranges from 3.00% to 2.50%; and (iii) for FILO Tranche is 5.00%.  The Revolving Credit Facilities mature on February 2, 2020, provided that if the Term Loan Facility (defined below) or the Real Estate Bridge Loan (defined below) is not refinanced with longer term debt or their terms not extended prior to their current maturities of December 4, 2017 and August 27, 2017, respectively, the Revolving Credit Facilities will mature 90 days prior to such maturity date, as applicable.  Borrowing levels under the Revolving Credit Facilities are limited to a borrowing base that is computed based upon the level of the Company’s eligible accounts receivable, as defined.  In addition to paying interest on the outstanding principal borrowed under the Revolving Credit Facilities, the Company is required to pay a commitment fee to the lenders for any unutilized commitments.  The commitment fee rate ranges from 0.375% per annum to 0.50% depending upon the level of unused commitment.
	Borrowings and interest rates under the three tranches were as follows at March 31, 2015:
					Weighted
					Average
	Revolving credit facility	Borrowings			Interest
	FILO tranche	$	25,000		5.36	%
	Tranche A-1	150,000			3.28	%
	Tranche A-2	75,000			2.76	%
		$	250,000		3.33	%
	As of March 31, 2015, the Company had outstanding borrowings under the Revolving Credit Facilities of $250.0 million and had $109.2 million of drawn letters of credit securing insurance and lease obligations, leaving the Company with approximately $165.8 million of available borrowing capacity under the revolving credit facilities.
	Term Loan Facility
	Prior to the Combination, FC-GEN and certain of its subsidiaries became a party to a five-year term loan facility (the Term Loan Facility).  The Term Loan Facility is secured by a first priority lien on the membership interests in the Company and on substantially all of the Company’s and its subsidiaries’ assets other than collateral held on a first priority basis by the Revolving Credit Facilities lender.  Borrowings under the Term Loan Facility bear interest at a rate per annum equal to the applicable margin plus, at the Company’s option, either (x) LIBOR or (y) a base rate determined by reference to the highest of (i) the lender defined prime rate, (ii) the federal funds rate effective plus one half of one percent and (iii) LIBOR described in subclause (x) plus 1.0%.  LIBOR based loans are subject to an interest rate floor of 1.5% and base rate loans are subject to a floor of 2.5%.  The Term Loan Facility matures on December 4, 2017.  On September 25, 2014, FC-GEN entered into an amendment to the Term Loan Facility providing for changes to the financial covenants and other provisions allowing for and accommodating the Combination.  On February 2, 2015, the amendment to the Term Loan Facility became effective.  The Term Loan Facility currently has an outstanding principal balance of $230.4 million.  Base rate borrowings under the Term Loan Facility bore interest of approximately 10.75% at March 31, 2015.  One-month LIBOR borrowings under the Term Loan Facility bore interest of approximately 10.0% at March 31, 2015.
	Principal payments for the three months ended March 31, 2015 were $0.3 million.  The Term Loan Facility amortizes at a rate of 5% per annum.  The lenders have the right to elect ratable principal payments or defer principal recoupment until the end of the term.
	Real Estate Bridge Loan
	In connection with the Combination on February 2, 2015, the Company entered into a $360.0 million real estate bridge loan (the Real Estate Bridge Loan), which is secured by a mortgage lien on the real property of 67 facilities and a second lien on certain receivables of the operators of such facilities.  The Real Estate Bridge Loan is subject to a 24-month term with two extension options of 90-days each and accrues interest at a rate equal to LIBOR, plus 6.75%, plus an additional margin that ranges up to 7.00% based on the aggregate number of days the Real Estate Bridge Loan is outstanding.  The interest rate is also subject to a LIBOR interest rate floor of 0.5%.  The Real Estate Bridge Loan bore interest of 7.25% at March 31, 2015.  The Real Estate Bridge Loan is subject to payments of interest only during the term with a balloon payment due at maturity, provided, that to the extent the subsidiaries receive any net proceeds from the sale and / or refinance of the underlying facilities such net proceeds are required to be used to repay the outstanding principal balance of the Real Estate Bridge Loan.   The proceeds of the Real Estate Bridge Loan were used to repay Skilled’s first lien senior secured term loan, repay Skilled’s mortgage loans and asset based revolving credit facility with MidCap Financial with excess proceeds used to fund direct costs of the Combination with the Company.  The Real Estate Bridge Loan has an outstanding principal balance of $360.0 million at March 31, 2015.
	The Revolving Credit Facilities, the Term Loan and Real Estate Bridge Loan (collectively, the Credit Facilities) each contain a number of restrictive covenants that, among other things, impose operating and financial restrictions on the Company and its subsidiaries.  The Credit Facilities also require the Company to meet defined financial covenants, including interest coverage ratio, a maximum consolidated net leverage ratio and a minimum consolidated fixed charge coverage ratio, all as defined in the applicable agreements.  The Credit Facilities also contain other customary covenants and events of default.  At March 31, 2015, the Company was in compliance with its covenants.
	HUD Insured Loans
	In connection with the Combination on February 2, 2015, the Company assumed certain obligations under 10 loans insured by HUD. The loans are secured by 10 of the Company’s skilled nursing facilities that were acquired in the Combination. The HUD insured loans have an average all in interest rate of approximately 5.3% and an original amortization term of 30 to 35 years. As of March 31, 2015 the HUD insured loans have a combined aggregate principal balance of $100.8 million including a $14.9 million debt premium established in purchase accounting in connection with the Combination.
	These mortgages have an average remaining term of 33 years with fixed interest rates ranging from 3.4% to 4.6% and a weighted average interest rate of 4.2%. Depending on the mortgage agreement, prepayments are generally allowed only after 12 months from the inception of the mortgage. Prepayments are subject to a penalty of 10% of the remaining principal balances in the first year and the prepayment penalty decreases each subsequent year by 1% until no penalty is required. Any further HUD insured mortgages will require additional HUD approval.
	All HUD-insured mortgages are non-recourse loans to the Company. All mortgages are subject to HUD regulatory agreements that require escrow reserve funds to be deposited with the loan servicer for mortgage insurance premiums, property taxes, insurance and for capital replacement expenditures. As of March 31, 2015, the Company has total escrow reserve funds of $4.9 million with the loan servicer that are reported within prepaid expenses.
	Other Debt
	Mortgages and other secured debt (recourse). The Company carries two mortgage loans on two of its corporate office buildings.  The Company has an outstanding note payable for an acquired facility.  The loans are secured by the underlying real property and have fixed or variable rates of interest ranging from 1.9% to 6.0% at March 31, 2015, with maturity dates ranging from 2018 to 2019.
	Mortgages and other secured debt (non-recourse). Loans are carried by certain of the Company’s consolidated joint ventures.  The loans consist principally of revenue bonds and secured bank loans.  Loans are secured by the underlying real and personal property of individual facilities and have fixed or variable rates of interest ranging from 2.5% to 21.9% at March 31, 2015, with maturity dates ranging from 2018 to 2036.  Loans are labeled “non-recourse” because neither the Company nor any of its wholly owned subsidiaries is obligated to perform under the respective loan agreements.
	The maturity of total debt of $993.7 million at March 31, 2015 is as follows (in thousands):
	Twelve months ending March 31,
	2016	$	12,829
	2017	372,972
	2018	218,687
	2019	13,842
	2020	254,380
	Thereafter	120,947
	Total debt payments	$	993,657

Leases_and_Lease_Commitments

Leases and Lease Commitments	3 Months Ended
	Mar. 31, 2015
Leases and Lease Commitments
Leases and Lease Commitments	(8)   Leases and Lease Commitments
	The Company leases certain facilities under capital and operating leases.  Future minimum payments for the next five years and thereafter under such leases at March 31, 2015 are as follows (in thousands):
	Twelve months ending March 31,	Capital Leases			Operating Leases
	2016	$	91,697		$	143,415
	2017	93,871			143,002
	2018	96,088			136,130
	2019	98,455			132,616
	2020	100,924			131,259
	Thereafter	3,027,741			373,463
	Total future minimum lease payments	3,508,776			$	1,059,885
	Less amount representing interest	(2,500,217		)
	Capital lease obligation	1,008,559
	Less current portion	(3,004		)
	Long-term capital lease obligation	$	1,005,555
	Capital Lease Obligations
	The capital lease obligations represent the present value of minimum lease payments under such capital lease and cease use arrangements and bear imputed interest at rates ranging from 3.5% to 12.8% at March 31, 2015, and mature at dates ranging from 2015 to 2045.
	Deferred Lease Balances
	At March 31, 2015 and December 31, 2014, the Company had $64.1 million and $47.8 million, respectively, of favorable leases net of accumulated amortization, included in other identifiable intangible assets, and $41.3 million and $31.4 million, respectively, of unfavorable leases net of accumulated amortization included in other long-term liabilities on the consolidated balance sheet.  Favorable and unfavorable lease assets and liabilities, respectively, arise through the acquisition of leases in place which requires those contracts be recorded at their then fair value.  The fair value of a lease is determined through a comparison of the actual rental rate with rental rates prevalent for similar assets in similar markets.  A favorable lease asset to the Company represents a rental stream that is below market, and conversely an unfavorable lease is one with cost above market rates.  These assets and liabilities amortize as lease expense over the remaining term of the respective leases on a straight-line basis.  At March 31, 2015 and December 31, 2014, the Company had $21.8 million and $20.6 million, respectively, of deferred straight-line rent balances included in other long-term liabilities on the consolidated balance sheet.
	Lease Covenants
	Certain lease agreements contain a number of restrictive covenants that, among other things and subject to certain exceptions, impose operating and financial restrictions on the Company and its subsidiaries.  These leases also require the Company to meet defined financial covenants, including a minimum level of consolidated liquidity, a maximum consolidated net leverage ratio, a minimum consolidated fixed charge coverage and a minimum level of tangible net worth.  At March 31, 2015, the Company was in compliance with its covenants under its lease arrangements.
	In connection with the Combination on February 2, 2015, the Company and certain of its lessors amended the existing lease agreements.  These amendments modified certain financial covenants to reflect the combined company.  There were no other significant changes to the lease agreements in the reporting period.

Financing_Obligation

Financing Obligation	3 Months Ended
	Mar. 31, 2015
Financing Obligation
Financing Obligation	(9)   Financing Obligation
	Future minimum payments for the next five years and thereafter under leases classified as financing obligations at March 31, 2015 are as follows (in thousands):
	Twelve months ending March 31,
	2016	$	262,053
	2017	270,608
	2018	278,319
	2019	286,253
	2020	294,241
	Thereafter	9,887,841
	Total future minimum lease payments	11,279,315
	Less amount representing interest	(8,349,219		)
	Financing obligation	$	2,930,096
	Less current portion	(1,098		)
	Long-term financing obligation	$	2,928,998

Income_Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2015
Income Tax Disclosure [Abstract]
Income Taxes	(10)  Income Taxes
	Upon completion of the Combination, the Company effectively owns 58% of FC-GEN, an entity taxed as a partnership for U.S. income tax purposes.  This is the Company’s only source of taxable income.  The transaction did not materially impact the percentage of pre-tax income taxed as corporate income.
	For the three months ended March 31, 2015, the Company recorded an income tax benefit of $5.6 million from continuing operations representing an effective tax rate of 4.6% compared to an income tax benefit of $2.8 million from continuing operations, representing an effective tax rate of 6.3% for the same period in 2014.  The 1.7% decrease in the effective tax rate is attributable to a higher amount of projected U.S. federal tax credits for the 2015 tax year and the write-off of a portion of deferred tax assets on U.S. federal and state net operating losses.  The write-off is a result of a more restrictive change of ownership limitation under IRC Section 382 by which a taxpayer is limited to a certain amount of net operating losses it can utilize in a given tax year.
	Exchange Rights and Tax Receivable Agreement
	Following the Combination, the owners of FC-GEN will have the right to exchange their membership interests in FC-GEN for shares of Class A Common Stock of the Company or cash, at the Company’s option.  As a result of such exchanges, the Company’s membership interest in FC-GEN will increase and its purchase price will be reflected in its share of the tax basis of FC-GEN’s tangible and intangible assets.  Any resulting increases in tax basis are likely to increase tax depreciation and amortization deductions and, therefore, reduce the amount of income tax the Company would otherwise be required to pay in the future.  Any such increase would also decrease gain (or increase loss) on future dispositions of the effected assets.
	Concurrent with the Combination, the Company entered into a tax receivable agreement (TRA) with the owners of FC-GEN.  The agreement provides for the payment by the Company to the owners of FC-GEN of 90% of the cash savings, if any, in U.S. federal, state and local income tax that the Company actually realizes as a result of (i) the increases in tax basis attributable to the owners of FC-GEN and (ii) tax benefits related to imputed interest deemed to be paid by the Company as a result of the TRA.  Under the TRA, the benefits deemed realized by the Company as a result of the increase in tax basis attributable to the owners of FC-GEN generally will be computed by comparing the actual income tax liability of the Company to the amount of such taxes that the Company would have been required to pay had there been no such increase in tax basis.
	Estimating the amount of payments that may be made under the TRA is by its nature imprecise, insofar as the calculation of amounts payable depends on a variety of factors. The actual increase in tax basis and deductions, as well as the amount and timing of any payments under the TRA, will vary depending upon a number of factors, including:
		·	the timing of exchanges—for instance, the increase in any tax deductions will vary depending on the fair value of the depreciable or amortizable assets of FC-GEN and its subsidiaries at the time of each exchange, which fair value may fluctuate over time;
		·	the price of shares of Company Class A Stock at the time of the exchange—the increase in any tax deductions, and the tax basis increase in other assets of FC-GEN and its subsidiaries is directly proportional to the price of shares of Company Class A Stock at the time of the exchange;
		·	the amount and timing of the Company’s income—the Company is required to pay 90% of the deemed benefits as and when deemed realized. If FC-GEN does not have taxable income, the Company is generally not required (absent a change of control or circumstances requiring an early termination payment) to make payments under the TRA for that taxable year because no benefit will have been actually realized.  However, any tax benefits that do not result in realized benefits in a given tax year likely will generate tax attributes that may be utilized to generate benefits in previous or future tax years. The utilization of such tax attributes will result in payments under the TRA; and
		·	future tax rates of jurisdictions in which the Company has tax liability.
	The TRA also provides that upon certain mergers, asset sales, other forms of business combinations or other changes of control, FC-GEN (or its successor’s) obligations under the TRA would be based on certain assumptions defined in the TRA. As a result of these assumptions, FC-GEN could be required to make payments under the TRA that are greater or less than the specified percentage of the actual benefits realized by the Company that are subject to the TRA.  In addition, if FC-GEN elects to terminate the TRA early, it would be required to make an early termination payment, which upfront payment may be made significantly in advance of the anticipated future tax benefits.
	Payments generally are due under the TRA within a specified period of time following the filing of FC-GEN’s U.S. federal and state income tax return for the taxable year with respect to which the payment obligation arises.  Payments under the TRA generally will be based on the tax reporting positions that FC-GEN will determine.  Although FC-GEN does not expect the IRS to challenge the Company’s tax reporting positions, FC-GEN will not be reimbursed for any overpayments previously made under the TRA, but any overpayments will reduce future payments.  As a result, in certain circumstances, payments could be made under the TRA in excess of the benefits that FC-GEN actually realizes in respect of the tax attributes subject to the TRA.
	The term of the TRA generally will continue until all applicable tax benefits have been utilized or expired, unless the Company exercises its right to terminate the TRA and make an early termination payment.
	In certain circumstances (such as certain changes in control, the election of the Company to exercise its right to terminate the agreement and make an early termination payment or an IRS challenge to a tax basis increase) it is possible that cash payments under the TRA may exceed actual cash savings.

Commitments_and_Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	(11) Commitments and Contingencies
	Loss Reserves For Certain Self-Insured Programs
	General and Professional Liability and Workers’ Compensation
	The Company self-insures for certain insurable risks, including general and professional liabilities and workers’ compensation liabilities through the use of self-insurance or retrospective and self-funded insurance policies and other hybrid policies, which vary among states in which the Company operates, including wholly owned captive insurance subsidiaries, to provide for potential liabilities for general and professional liability claims and workers’ compensation claims. Policies are typically written for a duration of twelve months and are measured on a “claims made” basis. Regarding workers’ compensation, the Company self-insures to its deductible and purchases statutory required insurance coverage in excess of its deductible. There is a risk that amounts funded to the Company’s self-insurance programs may not be sufficient to respond to all claims asserted under those programs. Insurance reserves represent estimates of future claims payments. This liability includes an estimate of the development of reported losses and losses incurred but not reported. Provisions for changes in insurance reserves are made in the period of the related coverage. The Company also considers amounts that may be recovered from excess insurance carriers in estimating the ultimate net liability for such risks.
	The Company’s management employs its judgment and periodically independent actuarial analysis in determining the adequacy of certain self-insured workers’ compensation and general and professional liability obligations recorded as liabilities in the Company’s financial statements. The Company evaluates the adequacy of its self-insurance reserves on a quarterly basis or more often when it is aware of changes to its incurred loss patterns that could impact the accuracy of those reserves. The methods of making such estimates and establishing the resulting reserves are reviewed periodically and are based on historical paid claims information and nationwide nursing home trends. The foundation for most of these methods is the Company’s actual historical reported and/or paid loss data, over which it has effective internal controls. Any adjustments resulting therefrom are reflected in current earnings. Claims are paid over varying periods, and future payments may be different than the estimated reserves.
	The Company utilizes third-party administrators (TPAs) to process claims and to provide it with the data utilized in its assessments of reserve adequacy. The TPAs are under the oversight of the Company’s in-house risk management and legal functions. These functions ensure that the claims are properly administered so that the historical data is reliable for estimation purposes. Case reserves, which are approved by the Company’s legal and risk management departments, are determined based on an estimate of the ultimate settlement and/or ultimate loss exposure of individual claims.
	The reserves for loss for workers’ compensation risks are discounted based on actuarial estimates of claim payment patterns using a discount rate of approximately 1% for each policy period presented. The discount rate for the 2015 policy year is 0.8%. The discount rates are based upon the risk-free rate for the appropriate duration for the respective policy year. The removal of discounting would have resulted in an increased reserve for workers’ compensation risks of $5.7 million and $4.8 million as of March 31, 2015 and December 31, 2014, respectively. The reserves for general and professional liability are recorded on an undiscounted basis.
	The provision for general and professional liability risks totaled $26.2 million and $22.4 million for the three months ended March 31, 2015 and 2014, respectively. The reserves for general and professional liability were $320.5 million and $288.2 million as of March 31, 2015 and December 31, 2014, respectively.
	The provision for loss for workers’ compensation risks totaled $18.0 million and $15.0 million for the three months ended March 31, 2015 and 2014, respectively. The reserves for workers’ compensation risks were $224.7 million and $198.0 million as of March 31, 2015 and December 31, 2014, respectively.
	Health Insurance
	The Company offers employees an option to participate in self-insured health plans.  Health insurance claims are paid as they are submitted to the plans’ administrators.  The Company maintains an accrual for claims that have been incurred but not yet reported to the plans’ administrators and therefore have not yet been paid.  The liability for the self-insured health plan is recorded in accrued compensation in the consolidated balance sheets.  Although management believes that the amounts provided in the Company’s consolidated financial statements are adequate and reasonable, there can be no assurances that the ultimate liability for such self-insured risks will not exceed management’s estimates.
	Legal Proceedings
	The Company is a party to litigation and regulatory investigations arising in the ordinary course of business.  With the exception of the specific matters noted below, management does not believe the results of such litigation and regulatory investigations, even if the outcome is unfavorable, would have a material adverse effect on the results of operations, financial position or cash flows of the Company.
	Creekside Hospice Litigation
	On August 2, 2013, the United States Attorney for the District of Nevada and the Civil Division of the U.S. Department of Justice (the DOJ) informed the Company that its Civil Division was investigating Skilled, as well as its subsidiary, Creekside Hospice II, LLC, for possible violations of federal and state healthcare fraud and abuse laws and regulations. Those laws could have included the federal False Claims Act (FCA) and the Nevada False Claims Act (NFCA). The FCA provides for civil and administrative fines and penalties, plus treble damages. The NFCA provides for similar fines and penalties, including treble damages. Violations of those federal or state laws could also subject the Company and/or its subsidiaries to exclusion from participation in the Medicare and Medicaid programs.
	On or about August 6, 2014, in relation to the investigation the DOJ filed a notice of intervention in two pending qui tam proceedings filed by private party relators under the FCA and the NFCA and advised that it intends to take over the actions. The DOJ filed its complaint in intervention on November 25, 2014, against Creekside, Skilled Healthcare Group, Inc., and Skilled Healthcare, LLC, asserting, among other things, that certain claims for hospice services provided by Creekside in the time period 2010 to 2013 did not meet Medicare requirements for reimbursement and are in violation of the civil False Claims Act.  The DOJ is pursuing False Claims Act, NFCA, and federal common law claims remedies in an unspecified amount, with a request to treble provable damages and impose penalties per proved false claim in the amount ranging from $5,500 to $11,000 per claim, as applicable.
	While the Company denies the allegations and will vigorously defend this action, including any portion of the action that the private party relators may continue to pursue, the Company has accrued $6.0 million as a contingent liability in connection with the matter. However, it could ultimately cost more than that amount to settle or otherwise resolve the matter(s), including to satisfy any judgment that might be rendered against the Company or Creekside Hospice if the litigation defense were ultimately unsuccessful.
	Therapy Matters Investigation
	In February 2015, representatives of the DOJ informed the Company that they are investigating and may pursue legal action against the Company and certain of its subsidiaries including Hallmark Rehabilitation GP, LLC for alleged violations of the federal and state healthcare fraud and abuse laws and regulations related to the provision of therapy services at certain Skilled Healthcare facilities from 2005 through 2013. These laws could include the FCA and similar state laws. As noted above, the FCA provides for civil and administrative fines and penalties, including civil fines ranging from $5,500 to $11,000 per claim plus treble damages. Applicable state laws provide for similar penalties. Violations of these federal or state laws could also subject the Company and/or its subsidiaries to exclusion from participation in the Medicare and Medicaid programs. Any damages, fines, penalties, other sanctions and costs that we may incur as a result of any federal and/or state suit could be significant and could have a material and adverse effect on our results of operations and financial condition. At this time, we cannot predict what effect, if any, the investigation or any potential claims arising under applicable federal or state laws and regulations could have on the Company. While the Company will continue to cooperate with the government’s investigation of the matter, the Company intends to vigorously defend against any legal action that may be brought in the matter.
	Staffing Matters Investigation
	On February 10, 2015, the DOJ informed the Company that it intends to pursue legal action against the Company and certain of its subsidiaries related to staffing and certain quality of care allegations related to the issues adjudicated against the Company and those subsidiaries in a previously disclosed class action lawsuit that Skilled settled in 2010. The laws under which the DOJ could seek to pursue legal action could include the FCA and similar state laws. As noted above, violations of the FCA or similar state laws and regulations could subject the Company and/or its subsidiaries to severe monetary and other penalties and remedies. Any damages, fines, penalties, other sanctions and costs that we may incur as a result of any federal or state suit could be significant and could have a material and adverse effect on our results of operations and financial condition. At this time, we cannot predict what effect, if any, the investigation or any potential claims arising under applicable federal or state laws and regulations could have on the Company. While the Company will continue to cooperate with the government’s evaluation of the matter, the Company intends to vigorously defend against any legal action that may be brought in the matter.

Fair_Value_of_Financial_Instru

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2015
Fair Value of Financial Instruments
Fair Value Measurements	(12) Fair Value of Financial Instruments
	The Company’s financial instruments consist primarily of cash and equivalents, restricted cash, trade accounts receivable, investments in marketable securities, accounts payable, short and long-term debt and derivative financial instruments.
	The Company’s  financial instruments, other than its trade accounts receivable and accounts payable, are spread across a number of large financial institutions whose credit ratings the Company monitors and believes do not currently carry a material risk of non-performance.  Certain of the Company’s financial instruments, including its interest rate cap arrangements, contain an off-balance-sheet risk.
	Recurring Fair Value Measures
	Fair value is defined as an exit price (i.e., the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date).  The fair value hierarchy prioritizes the inputs to valuation techniques used to measure fair value into three broad levels as shown below.  An instrument’s classification within the fair value hierarchy is determined based on the lowest level input that is significant to the fair value measurement.
	Level 1 —	Quoted prices (unadjusted) in active markets for identical assets or liabilities.
	Level 2 —	Inputs that are observable for the asset or liability, either directly or indirectly through market corroboration, for substantially the full term of the asset or liability.
	Level 3 —	Inputs that are unobservable for the asset or liability based on the Company’s own assumptions (about the assumptions market participants would use in pricing the asset or liability).
	The tables below presents the Company’s assets and liabilities measured at fair value on a recurring basis as of March 31, 2015 and December 31, 2014, aggregated by the level in the fair value hierarchy within which those measurements fall (in thousands):
		Fair Value Measurements at Reporting Date Using
		March 31,		Quoted Prices in		Significant Other		Significant
				Active Markets		Observable		Unobservable
				for Identical		Inputs		Inputs
				Assets
		2015		(Level 1)		(Level 2)		(Level 3)
	Assets:
	Cash and equivalents	$	95,708	$	95,708	$	—	$	—
	Restricted cash and equivalents	39,134		39,134		—		—
	Restricted investments in marketable securities	133,647		133,647		—		—
	Total	$	268,489	$	268,489	$	—	$	—
		Fair Value Measurements at Reporting Date Using
		December 31,		Quoted Prices in		Significant Other		Significant
				Active Markets		Observable		Unobservable
				for Identical		Inputs		Inputs
				Assets
		2014		(Level 1)		(Level 2)		(Level 3)
	Assets:
	Cash and equivalents	$	87,548	$	87,548	$	—	$	—
	Restricted cash and equivalents	36,390		36,390		—		—
	Restricted investments in marketable securities	110,350		110,350		—		—
	Total	$	234,288	$	234,288	$	—	$	—
	The Company places its cash and equivalents and restricted investments in marketable securities in quality financial instruments and limits the amount invested in any one institution or in any one type of instrument.  The Company has not experienced any significant losses on such investments.
	Debt Instruments
	The table below shows the carrying amounts and estimated fair values of the Company’s primary long-term debt instruments:
		March 31, 2015				December 31, 2014
		Carrying Value		Fair Value		Carrying Value		Fair Value
	Revolving credit facility	$	250,000	$	250,000	$	254,500	$	254,500
	Term loan facility, net of original issue discount of $10,400 at March 31, 2015 and $11,375 at December 31, 2014	219,964		223,996		219,297		229,677
	Real estate bridge loan	360,000		360,000		—		—
	HUD insured loans	100,845		100,845		—		—
	Mortgages and other secured debt (recourse)	13,370		13,370		14,488		14,488
	Mortgages and other secured debt (non recourse)	49,478		49,478		49,961		49,961
		$	993,657	$	997,689	$	538,246	$	548,626
	The fair value of debt is based upon market prices or is computed using discounted cash flow analysis, based on the Company’s estimated borrowing rate at the end of each fiscal period presented.  The Company believes that the inputs to the pricing models qualify as Level 2 measurements.
	Non-Recurring Fair Value Measures
	The Company recently applied the fair value measurement principles to certain of its non-recurring nonfinancial assets in connection with an impairment test.
	The following table presents the Company’s hierarchy for nonfinancial assets measured at fair value on a non-recurring basis (in thousands):
		Carrying Value		Impairment Charges -
		March 31, 2015		Three Months Ended
				March 31, 2015
	Assets:
	Property and equipment, net	$	3,947,941	$	—
	Goodwill	423,387		—
	Intangible assets	233,181		—
		Carrying Value		Impairment Charges -
		December 31, 2014		Three Months Ended
				March 31, 2014
	Assets:
	Property and equipment, net	$	3,493,250	$	—
	Goodwill	169,681		—
	Intangible assets	173,112		—
	The fair value of tangible and intangible assets is determined using a discounted cash flow approach, which is a significant unobservable input (Level 3).  The Company estimates the fair value using the income approach (which is a discounted cash flow technique).  These valuation methods required management to make various assumptions, including, but not limited to, future profitability, cash flows and discount rates.  The Company’s estimates are based upon historical trends, management’s knowledge and experience and overall economic factors, including projections of future earnings potential.
	Developing discounted future cash flows in applying the income approach requires the Company to evaluate its intermediate to longer-term strategies, including, but not limited to, estimates of revenue growth, operating margins, capital requirements, inflation and working capital management.  The development of appropriate rates to discount the estimated future cash flows requires the selection of risk premiums, which can materially impact the present value of future cash flows.
	The Company estimated the fair value of acquired tangible and intangible assets using discounted cash flow techniques that included an estimate of future cash flows, consistent with overall cash flow projections used to determine the purchase price paid to acquire the business, discounted at a rate of return that reflects the relative risk of the cash flows.
The Company believes the estimates and assumptions used in the valuation methods are reasonable.

Subsequent_Event

Subsequent Event	3 Months Ended
	Mar. 31, 2015
Subsequent Events
Subsequent Events	(13) Subsequent Events
	On April 1, 2015, the Company amended a master lease agreement with a major landlord real estate investment trust.  The amendment resulted in a one-time buyout of rent for eight previously closed facilities for a payment of $9.1 million.  The Company has the option to close six other facilities over the next two years if certain conditions are met.  The initial term of the lease was extended by two years expiring December 31, 2027.

General_Information_Policies

General Information (Policies)	3 Months Ended
	Mar. 31, 2015
General Information
Description of Business	Description of Business
	Genesis Healthcare, Inc. is a healthcare services company that through its subsidiaries (collectively, the Company) owns and operates skilled nursing facilities, assisted living facilities, hospices, home health providers and a rehabilitation therapy business.  The Company has an administrative service company that provides a full complement of administrative and consultative services that allows our affiliated operators and third-party operators with whom the Company contracts to better focus on delivery of healthcare services. The Company provides inpatient services through 511 skilled nursing, assisted living and behavioral health centers located in 34 states.  Revenues of the Company’s owned, leased and otherwise consolidated centers constitute approximately 85% of its revenues.
	The Company provides a range of rehabilitation therapy services, including speech pathology, physical therapy, occupational therapy and respiratory therapy.  These services are provided by rehabilitation therapists and assistants employed or contracted at substantially all of the centers operated by the Company, as well as by contract to healthcare facilities operated by others.  After the elimination of intercompany revenues, the rehabilitation therapy services business constitutes approximately 12% of the Company’s revenues.
	The Company provides an array of other specialty medical services, including management services, physician services, staffing services, hospice and home health services, and other healthcare related services, which comprise the balance of the Company’s revenues.
Basis of Presentation	Basis of Presentation
	The accompanying consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles.  In the opinion of management, the consolidated financial statements include all necessary adjustments for a fair presentation of the financial position and results of operations for the periods presented.
	The accompanying unaudited consolidated financial statements have been prepared in accordance with the instructions for Form 10-Q of Regulation S-X and do not include all of the disclosures normally required by generally accepted accounting principles or those normally required in annual reports on Form 10-K. Accordingly, these financial statements should be read in conjunction with the audited consolidated financial statements of the Company for the year ended December 31, 2014 filed with the Securities and Exchange Commission on Form 8-K/A on February 26, 2015. The accompanying consolidated balance sheet at December 31, 2014 was derived from audited consolidated financial statements, but does not include all disclosures required by generally accepted accounting principles.
	Certain prior year amounts have been reclassified to conform to current period presentation, the effect of which was not material.  The Company’s membership interest at December 31, 2014 has been recast as common stock and additional paid-in capital.
	The Company’s financial position at March 31, 2015 includes the impact of the Combination (as defined in Note 3 —  “Significant Transactions and Events — The Combination with Skilled”), which has been accounted for as a reverse acquisition using the acquisition method effective February 2, 2015.
Recent Accounting Pronouncements	Recent Accounting Pronouncements
	In May 2014, the Financial Accounting Standards Board (the FASB) issued ASU No. 2014-09, Revenue from Contracts with Customers, (ASU 2014-09) which changes the requirements for recognizing revenue when entities enter into contracts with customers. Under ASU 2014-09, an entity will recognize revenue when it transfers promised goods or services to customers in an amount that reflects what it expects in exchange for the goods or services. It also requires more detailed disclosures to enable users of financial statements to understand the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The adoption of ASU 2014-09 is effective for annual and interim periods beginning after December 15, 2017 and early adoption is not permitted. The Company is still evaluating the effect, if any, ASU 2014-09 will have on the Company’s consolidated financial condition and results of operations.
	In April 2015, the FASB issued ASU No. 2015-03, Simplifying the Presentation of Debt Issuance Costs, (ASU 2015-03). This ASU requires an entity to present debt issuance costs as a direct deduction from the carrying amount of the related debt liability, consistent with debt discounts.  The costs will continue to be amortized to interest expense using the effective interest method. The adoption of ASU 2015-03 is effective for fiscal years beginning after December 15, 2015, and interim periods within those fiscal years, with early adoption permitted. This ASU requires retrospective application to all prior periods presented in the financial statements.  The adoption of ASU No. 2015-03 is not expected to have a material impact on the Company’s consolidated financial condition and results of operations.

Significant_Transactions_and_E1

Significant Transactions and Events (Tables)	3 Months Ended
	Mar. 31, 2015
Significant Transactions and Events
Schedule of allocation of purchase price	The consideration price and related allocation are summarized as follows (in thousands):
	Accounts receivable	$	128,782
	Deferred income taxes and other current assets	42,533
	Property, plant and equipment	495,692
					Weighted
					Average Life
					(Years)
	Identifiable intangible assets:
	Management contracts	30,900			3.5
	Customer relationships	13,400			10
	Favorable lease contracts	18,220			12.8
	Trade names	3,400			Indefinite
	Total identifiable intangible assets	65,920
	Deferred income taxes and other assets	59,196
	Accounts payable and other current liabilities	(115,292		)
	Long-term debt, including amounts due within one year	(428,342		)
	Unfavorable lease contracts	(11,480		)
	Deferred income taxes and other long-term liabilities	(142,574		)
	Total identifiable net assets	94,435
	Goodwill	253,705
	Net assets	$	348,140
Schedule of pro forma information	The unaudited pro forma net effect of the Combination assuming the acquisition occurred as of January 1, 2014 is as follows (in thousands, except per share amounts):
		Pro Forma Three months ended March 31,
		2015			2014
	Revenues	$	1,414,289		$	1,393,844
	Loss attributable to Genesis Healthcare, Inc.	(16,317		)	(17,568		)
	Loss per share from continuing operations attributable to Genesis Healthcare, Inc.
	Basic	(0.18		)	(0.16		)
	Diluted	(0.19		)	(0.22		)

Earnings_Loss_Per_Share_Tables

Earnings (Loss) Per Share (Tables)	3 Months Ended
	Mar. 31, 2015
Earnings (Loss) Per Share
Schedule of Earnings Per Share, Basic and Diluted (in thousands, except per share data)	A reconciliation of the numerator and denominator used in the calculation of basic and diluted net income per common share follows (in thousands, except per share data):
		Three Months Ended March 31,
		2015			2014
	Numerator:
	Loss from continuing operations	$	(118,362	)	$	(40,788	)
	Less: Net (loss) income attributable to noncontrolling interests	(5,684		)	185
	Loss from continuing operations attributable to Genesis Healthcare, Inc.	(112,678		)	(40,973		)
	Income (loss) from discontinued operations, net of income tax	112			(3,194		)
	Net loss attributable to Genesis Healthcare, Inc.	$	(112,566	)	$	(44,167	)
	Denominator:
	Weighted average shares outstanding for basic and diluted net loss per share	75,234			49,865
	Basic and diluted net loss per common share:
	Loss from continuing operations attributable to Genesis Healthcare, Inc.	$	(1.50	)	$	(0.82	)
	Income (loss) from discontinued operations	—			(0.06		)
	Net loss attributable to Genesis Healthcare, Inc.	$	(1.50	)	$	(0.88	)
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share (in thousands)	The following were excluded from net income attributed to Genesis Healthcare, Inc. and the weighted-average diluted shares computation for the three months ended March 31, 2015 and 2014, as their inclusion would have been anti-dilutive (shares in thousands):
		Three Months Ended March 31,
		2015					2014
		Net loss					Net loss
		attributed to					attributed to
		Genesis Healthcare,			Anti-dillutive		Genesis Healthcare,		Anti-dillutive
		Inc.			shares		Inc.		shares
	Exchange of restricted stock units of noncontrolling interests	$	(4,217	)	41,534		$	—	—

Segment_Information_Tables

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2015
Segment Information
Schedule of condensed consolidated statements of operations and total assets	A summary of the Company’s unaudited condensed consolidated statement of operations follows:
		Three months ended March 31, 2015
		Inpatient			Rehabilitation		Other Services		Corporate			Eliminations			Consolidated
		Services			Therapy
					Services
		(In thousands)
	Net revenues	$	1,145,009		$	263,051	$	52,336	$	210		$	(117,605	)	$	1,343,001
	Salaries, wages and benefits	542,692			214,797		33,244		29,205			—			819,938
	Other operating expenses	419,306			19,226		15,074		12,283			(117,604		)	348,285
	Lease expense	35,528			41		459		391			—			36,419
	Depreciation and amortization expense	48,225			2,867		362		8,479			—			59,933
	Interest expense	103,654			1		10		17,771			(123		)	121,313
	Loss on extinguishment of debt	—			—		—		3,234			—			3,234
	Investment income	(358		)	—		—		(181		)	123			(416		)
	Other income				—		—		(7,611		)	—			(7,611		)
	Transaction costs	371			—		—		85,698			—			86,069
	Equity in net (income) loss of unconsolidated affiliates	(309		)	—		—		(220		)	376			(153		)
	(Loss) income before income tax benefit	(4,100		)	26,119		3,187		(148,839		)	(377		)	(124,010		)
	Income tax benefit	—			—		—		(5,648		)	—			(5,648		)
	(Loss) income from continuing operations	$	(4,100	)	$	26,119	$	3,187	$	(143,191	)	$	(377	)	$	(118,362	)
		Three months ended March 31, 2014
		Inpatient			Rehabilitation		Other Services		Corporate			Eliminations			Consolidated
		Services			Therapy
					Services
		(In thousands)
	Net revenues	$	1,000,217		$	255,324	$	35,814	$	137		$	(104,948	)	$	1,186,544
	Salaries, wages and benefits	491,072			206,149		24,039		25,230			—			746,490
	Other operating expenses	357,623			18,930		10,460		10,633			(104,948		)	292,698
	Lease expense	32,320			44		213		222			—			32,799
	Depreciation and amortization expense	40,220			2,787		250		4,243			—			47,500
	Interest expense	96,460			1		209		12,203			(123		)	108,750
	Loss on extinguishment of debt	—			—		—		499			—			499
	Investment income	(424		)	—		—		(642		)	123			(943		)
	Transaction costs	—			—		—		2,249			—			2,249
	Equity in net (income) loss of unconsolidated affiliates	(290		)	—		—		—			334			44
	(Loss) income before income tax benefit	(16,764		)	27,413		643		(54,500		)	(334		)	(43,542		)
	Income tax benefit	—			—		—		(2,754		)	—			(2,754		)
	(Loss) income from continuing operations	$	(16,764	)	$	27,413	$	643	$	(51,746	)	$	(334	)	$	(40,788	)
	The following table presents the segment assets as of March 31, 2015 compared to December 31, 2014 (in thousands):
		March 31, 2015			December 31, 2014
	Inpatient services	$	5,239,633		$	4,381,044
	Rehabilitation services	416,652			322,268
	Other services	93,216			44,814
	Corporate and eliminations	281,855			393,282
	Total assets	$	6,031,356		$	5,141,408

Property_and_Equipment_Tables

Property and Equipment (Tables)	3 Months Ended
	Mar. 31, 2015
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment (in thousands)	Property and equipment consisted of the following as of March 31, 2015 and December 31, 2014 (in thousands):
		March 31, 2015			December 31, 2014
	Land, buildings and improvements	$	594,970		$	225,536
	Capital lease land, buildings and improvements	913,814			910,820
	Financing obligation land, buildings and improvements	2,549,389			2,526,792
	Equipment, furniture and fixtures	411,446			276,983
	Construction in progress	34,150			55,295
	Gross property and equipment	4,503,769			3,995,426
	Less: accumulated depreciation	(555,828		)	(502,176		)
	Net property and equipment	$	3,947,941		$	3,493,250

Longterm_Debt_Tables

Long-term Debt (Tables)	3 Months Ended
	Mar. 31, 2015
Long-Term Debt Abstract
Schedule of long-term debt (in thousands)	Long-term debt at March 31, 2015 and December 31, 2014 consisted of the following (in thousands):
		March 31, 2015			December 31, 2014
	Revolving credit facility	$	250,000		$	254,500
	Term loan facility, net of original issue discount of $10,400 at March 31, 2015 and $11,375 at December 31, 2014	219,964			219,297
	Real estate bridge loan	360,000			—
	HUD insured loans	100,845			—
	Mortgages and other secured debt (recourse)	13,370			14,488
	Mortgages and other secured debt (non recourse)	49,478			49,961
		993,657			538,246
	Less:
	Current installments of long-term debt	(12,746		)	(12,518		)
	Long-term debt	$	980,911		$	525,728
Schedule of borrowings and interest rates for revolving credit facility	Borrowings and interest rates under the three tranches were as follows at March 31, 2015:
					Weighted
					Average
	Revolving credit facility	Borrowings			Interest
	FILO tranche	$	25,000		5.36	%
	Tranche A-1	150,000			3.28	%
	Tranche A-2	75,000			2.76	%
		$	250,000		3.33	%
Schedule of maturity of total debt (in thousands)	The maturity of total debt of $993.7 million at March 31, 2015 is as follows (in thousands):
	Twelve months ending March 31,
	2016	$	12,829
	2017	372,972
	2018	218,687
	2019	13,842
	2020	254,380
	Thereafter	120,947
	Total debt payments	$	993,657

Leases_and_Lease_Commitments_T

Leases and Lease Commitments (Tables)	3 Months Ended
	Mar. 31, 2015
Leases and Lease Commitments
Schedule of future minimum lease payments for capital and operating leases	The Company leases certain facilities under capital and operating leases.  Future minimum payments for the next five years and thereafter under such leases at March 31, 2015 are as follows (in thousands):
	Twelve months ending March 31,	Capital Leases			Operating Leases
	2016	$	91,697		$	143,415
	2017	93,871			143,002
	2018	96,088			136,130
	2019	98,455			132,616
	2020	100,924			131,259
	Thereafter	3,027,741			373,463
	Total future minimum lease payments	3,508,776			$	1,059,885
	Less amount representing interest	(2,500,217		)
	Capital lease obligation	1,008,559
	Less current portion	(3,004		)
	Long-term capital lease obligation	$	1,005,555

Financing_Obligation_Tables

Financing Obligation (Tables)	3 Months Ended
	Mar. 31, 2015
Financing Obligation
Schedule of Future Minimum Lease Payments for Sale-Leaseback Obligation	Future minimum payments for the next five years and thereafter under leases classified as financing obligations at March 31, 2015 are as follows (in thousands):
	Twelve months ending March 31,
	2016	$	262,053
	2017	270,608
	2018	278,319
	2019	286,253
	2020	294,241
	Thereafter	9,887,841
	Total future minimum lease payments	11,279,315
	Less amount representing interest	(8,349,219		)
	Financing obligation	$	2,930,096
	Less current portion	(1,098		)
	Long-term financing obligation	$	2,928,998

Fair_Value_of_Financial_Instru1

Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2015
Fair Value of Financial Instruments
Schedule of fair value of assets measured on a recurring basis	The tables below presents the Company’s assets and liabilities measured at fair value on a recurring basis as of March 31, 2015 and December 31, 2014, aggregated by the level in the fair value hierarchy within which those measurements fall (in thousands):
		Fair Value Measurements at Reporting Date Using
		March 31,		Quoted Prices in		Significant Other		Significant
				Active Markets		Observable		Unobservable
				for Identical		Inputs		Inputs
				Assets
		2015		(Level 1)		(Level 2)		(Level 3)
	Assets:
	Cash and equivalents	$	95,708	$	95,708	$	—	$	—
	Restricted cash and equivalents	39,134		39,134		—		—
	Restricted investments in marketable securities	133,647		133,647		—		—
	Total	$	268,489	$	268,489	$	—	$	—
		Fair Value Measurements at Reporting Date Using
		December 31,		Quoted Prices in		Significant Other		Significant
				Active Markets		Observable		Unobservable
				for Identical		Inputs		Inputs
				Assets
		2014		(Level 1)		(Level 2)		(Level 3)
	Assets:
	Cash and equivalents	$	87,548	$	87,548	$	—	$	—
	Restricted cash and equivalents	36,390		36,390		—		—
	Restricted investments in marketable securities	110,350		110,350		—		—
	Total	$	234,288	$	234,288	$	—	$	—
Schedule of carrying amounts and fair values of long-term debt instruments
		March 31, 2015				December 31, 2014
		Carrying Value		Fair Value		Carrying Value		Fair Value
	Revolving credit facility	$	250,000	$	250,000	$	254,500	$	254,500
	Term loan facility, net of original issue discount of $10,400 at March 31, 2015 and $11,375 at December 31, 2014	219,964		223,996		219,297		229,677
	Real estate bridge loan	360,000		360,000		—		—
	HUD insured loans	100,845		100,845		—		—
	Mortgages and other secured debt (recourse)	13,370		13,370		14,488		14,488
	Mortgages and other secured debt (non recourse)	49,478		49,478		49,961		49,961
		$	993,657	$	997,689	$	538,246	$	548,626
Schedule of nonfinancial assets measured at fair value on a nonrecurring basis	The following table presents the Company’s hierarchy for nonfinancial assets measured at fair value on a non-recurring basis (in thousands):
		Carrying Value		Impairment Charges -
		March 31, 2015		Three Months Ended
				March 31, 2015
	Assets:
	Property and equipment, net	$	3,947,941	$	—
	Goodwill	423,387		—
	Intangible assets	233,181		—
		Carrying Value		Impairment Charges -
		December 31, 2014		Three Months Ended
				March 31, 2014
	Assets:
	Property and equipment, net	$	3,493,250	$	—
	Goodwill	169,681		—
	Intangible assets	173,112		—

General_Information_Details

General Information (Details)	3 Months Ended
	Mar. 31, 2015
	facility
	state
Inpatient Services
Facility Count
Number of skilled nursing and assisted living facilities	511
Number of states with facilities	34
Inpatient Services | Revenue | Product Concentration Risk [Member]
Facility Count
Concentration risk (as a percent)	85.00%
Rehabilitation Therapy Services | Revenue | Product Concentration Risk [Member]
Facility Count
Concentration risk (as a percent)	12.00%

Certain_Significant_Risks_and_1

Certain Significant Risks and Uncertainties (Details) (Government contracts, Revenue, Inpatient Services)	3 Months Ended
	Mar. 31, 2015
Government contracts | Revenue | Inpatient Services
Concentration Risk
Concentration risk (as a percent)	79.00%

Significant_Transactions_and_E2

Significant Transactions and Events (Details) (USD $)	3 Months Ended		0 Months Ended		2 Months Ended	0 Months Ended
	Mar. 31, 2015	Mar. 31, 2014	Aug. 17, 2014	Aug. 18, 2014	Mar. 31, 2015	Feb. 02, 2015	Dec. 31, 2014
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Goodwill	$423,387,000				$423,387,000		$169,681,000
Business Acquisition, Pro Forma Information [Abstract]
Revenues	1,414,289,000	1,393,844,000
Loss attributable to Genesis Healthcare, Inc.	-16,317,000	-17,568,000
Net loss per share, Basic	($0.18)	($0.16)
Net loss per share, Diluted	($0.19)	($0.22)
Former owners of FC-GEN
Business Acquisition [Line Items]
Direct controlling interest held pre-transaction (as a percent)			58.00%
Economic voting interest held pre-transaction (as a percent)			74.25%
Former Owners of FC-Gen and Skilled Healthcare
Business Acquisition [Line Items]
Noncontrolling interest held after transaction (as a percent)				42.00%
Convertible noncontrolling interest (as a percent)				42.00%
Conversion ratio				1
FC-GEN Operations Investment, LLC
Business Acquisition [Line Items]
Goodwill, tax deductible portion						79,800,000
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Accounts receivable						128,782,000
Deferred income taxes and other current assets						42,533,000
Property, plant and equipment						495,692,000
Identifiable intangible assets						65,920,000
Deferred income taxes and other assets						59,196,000
Accounts payable and other current liabilities						-115,292,000
Long-term debt, including amounts due within one year						-428,342,000
Unfavorable lease contracts						-11,480,000
Deferred income taxes and other long-term liabilities						-142,574,000
Total identifiable net assets						94,435,000
Goodwill						253,705,000
Net assets						348,140,000
Business Acquisition, Pro Forma Information [Abstract]
Revenue of acquiree					152,700,000
Net income of acquiree					5,300,000
Transaction costs in acquisition	84,700,000				84,700,000
FC-GEN Operations Investment, LLC | Trade names
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Indefinite lived intangible assets						3,400,000
FC-GEN Operations Investment, LLC | Management contracts
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Finite lived intangible assets						30,900,000
Weighted average life (in years)						3 years 6 months
FC-GEN Operations Investment, LLC | Customer relationships
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Finite lived intangible assets						13,400,000
Weighted average life (in years)						10 years
FC-GEN Operations Investment, LLC | Favorable lease contracts
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]
Finite lived intangible assets						$18,220,000
Weighted average life (in years)						12 years 9 months 18 days
FC-GEN Operations Investment, LLC | Former owners of FC-GEN
Business Acquisition [Line Items]
Investment in joint venture (as a percent)						74.25%
FC-GEN Operations Investment, LLC | Former shareholders of Skilled Healthcare Group, Inc.
Business Acquisition [Line Items]
Noncontrolling interest held after transaction (as a percent)						25.75%

Significant_Transactions_and_E3

Significant Transactions and Events - Related Party Transactions (Details) (USD $)	3 Months Ended	0 Months Ended
	Mar. 31, 2015	Mar. 31, 2015
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale of investment in joint venture	$26,358,000
FC PAC | Formation Capital
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Investment in joint venture (as a percent)	5.40%	5.40%
Sale of investment in joint venture		26,400,000
Gain on sale of equity investments		$8,400,000

Earnings_Loss_Per_Share_Detail

Earnings (Loss) Per Share (Details) (USD $)	3 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
	class
Income Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Number of classes of common stock	3
Numerator:
Loss from continuing operations	($118,362)	($40,788)
Less net loss (income) attributable to noncontrolling interests	-5,684	185
Loss from continuing operations	-112,678	-40,973
Income (loss) from discontinued operations, net of income tax	112	-3,194
Net Income (Loss) Attributable to Parent	($112,566)	($44,167)
Denominator:
Weighted-average shares outstanding for basic and diluted net loss per share	75,234	49,865
Loss from continuing operations attributable to Genesis Healthcare, Inc.	($1.50)	($0.82)
Income (loss) from discontinued operations		($0.06)
Net loss attributable to Genesis Healthcare, Inc.	($1.50)	($0.88)
Class C Common Stock
Income Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Voting ratio	1
Number of classes of stock that share voting ratio	2
Convertible noncontrolling interest (as a percent)	42.00%

Earnings_Loss_Per_Share_Schedu

Earnings (Loss) Per Share - Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) (USD $)	3 Months Ended
In Thousands, except Share data, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
Restricted Stock Units (RSUs)
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Net loss attributed to Genesis Healthcare, Inc	-4,217
Antidilutive shares	41,534,000
Class C Common Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive shares	64,449,380	0
Convertible noncontrolling interest (as a percent)	42.00%

Segment_Information_Segment_Re

Segment Information - Segment Reporting (Details) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014
	segment
Segment Reporting Information
Number of Reportable Segments	3
Net revenues	$1,343,001	$1,186,544
Salaries, wages and benefits	819,938	746,490
Other operating expenses	348,285	292,698
Lease expense	36,419	32,799
Depreciation and amortization expense	59,933	47,500
Interest expense	121,313	108,750
Loss on early extinguishment of debt	3,234	499
Investment income	-416	-943
Other income	-7,611
Transaction costs	86,069	2,249
Equity in net (income) loss of unconsolidated affiliates	-153	44
(Loss) income before income tax benefit	-124,010	-43,542
Income tax benefit	-5,648	-2,754
(Loss) income from continuing operations	-118,362	-40,788
Operating Segments | Inpatient Services
Segment Reporting Information
Net revenues	1,145,009	1,000,217
Salaries, wages and benefits	542,692	491,072
Other operating expenses	419,306	357,623
Lease expense	35,528	32,320
Depreciation and amortization expense	48,225	40,220
Interest expense	103,654	96,460
Investment income	-358	-424
Transaction costs	371
Equity in net (income) loss of unconsolidated affiliates	-309	-290
(Loss) income before income tax benefit	-4,100	-16,764
(Loss) income from continuing operations	-4,100	-16,764
Operating Segments | Rehabilitation Therapy Services
Segment Reporting Information
Net revenues	263,051	255,324
Salaries, wages and benefits	214,797	206,149
Other operating expenses	19,226	18,930
Lease expense	41	44
Depreciation and amortization expense	2,867	2,787
Interest expense	1	1
(Loss) income before income tax benefit	26,119	27,413
(Loss) income from continuing operations	26,119	27,413
Operating Segments | Other Services
Segment Reporting Information
Net revenues	52,336	35,814
Salaries, wages and benefits	33,244	24,039
Other operating expenses	15,074	10,460
Lease expense	459	213
Depreciation and amortization expense	362	250
Interest expense	10	209
(Loss) income before income tax benefit	3,187	643
(Loss) income from continuing operations	3,187	643
Corporate, Non-Segment | Corporate
Segment Reporting Information
Net revenues	210	137
Salaries, wages and benefits	29,205	25,230
Other operating expenses	12,283	10,633
Lease expense	391	222
Depreciation and amortization expense	8,479	4,243
Interest expense	17,771	12,203
Loss on early extinguishment of debt	3,234	499
Investment income	-181	-642
Other income	-7,611
Transaction costs	85,698	2,249
Equity in net (income) loss of unconsolidated affiliates	-220
(Loss) income before income tax benefit	-148,839	-54,500
Income tax benefit	-5,648	-2,754
(Loss) income from continuing operations	-143,191	-51,746
Elimination | Elimination
Segment Reporting Information
Net revenues	-117,605	-104,948
Other operating expenses	-117,604	-104,948
Interest expense	-123	-123
Investment income	123	123
Equity in net (income) loss of unconsolidated affiliates	376	334
(Loss) income before income tax benefit	-377	-334
(Loss) income from continuing operations	($377)	($334)

Segment_Information_Assets_by_

Segment Information - Assets by Segment (Details) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Segment Reporting, Asset Reconciling Item
Segment total assets	$6,031,356	$5,141,408
Corporate and Eliminations
Segment Reporting, Asset Reconciling Item
Segment total assets	281,855	393,282
Inpatient Services
Segment Reporting, Asset Reconciling Item
Segment total assets	5,239,633	4,381,044
Rehabilitation Therapy Services
Segment Reporting, Asset Reconciling Item
Segment total assets	416,652	322,268
Other Services
Segment Reporting, Asset Reconciling Item
Segment total assets	$93,216	$44,814

Property_and_Equipment_Schedul

Property and Equipment - Schedule of Property and Equipment (Details) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Property, Plant and Equipment [Abstract]
Land and land improvements	$594,970	$225,536
Capital lease land, buildings and improvements	913,814	910,820
Financing obligation land, buildings and improvements	2,549,389	2,526,792
Equipment, furniture and fixtures	411,446	276,983
Construction in progress	34,150	55,295
Gross property and equipment	4,503,769	3,995,426
Less accumulated depreciation	-555,828	-502,176
Net property and equipment	$3,947,941	$3,493,250

LongTerm_Debt_Credit_Facility_

Long-Term Debt - Credit Facility and Term Loans (Details) (USD $)	0 Months Ended	3 Months Ended
	Feb. 02, 2015	Mar. 31, 2015	Dec. 31, 2014	Dec. 31, 2015
Debt Instrument
Total debt		$993,657,000	$538,246,000
Current installments of long-term debt		-12,746,000	-12,518,000
Long-term Debt, Excluding Current Maturities, Total		980,911,000	525,728,000
Outstanding borrowings under the revolving credit facilities		250,000,000
Weighted Average Interest Rate		3.33%
Revolving Credit Facility Tranche 1 [Member]
Debt Instrument
Outstanding borrowings under the revolving credit facilities		150,000,000
Weighted Average Interest Rate		3.28%
Revolving Credit Facility Tranche 1 [Member] | LIBOR | Minimum
Debt Instrument
Basis spread on variable rate	3.25%
Revolving Credit Facility Tranche 1 [Member] | LIBOR | Maximum
Debt Instrument
Basis spread on variable rate	2.75%
Revolving Credit Facility Tranche 2 [Member]
Debt Instrument
Outstanding borrowings under the revolving credit facilities		75,000,000
Weighted Average Interest Rate		2.76%
Revolving Credit Facility Tranche 2 [Member] | LIBOR | Minimum
Debt Instrument
Basis spread on variable rate	3.00%
Revolving Credit Facility Tranche 2 [Member] | LIBOR | Maximum
Debt Instrument
Basis spread on variable rate	2.50%
Revolving Credit Facility FILO Tranche [Member]
Debt Instrument
Outstanding borrowings under the revolving credit facilities		25,000,000
Weighted Average Interest Rate		5.36%
Revolving Credit Facility FILO Tranche [Member] | LIBOR
Debt Instrument
Basis spread on variable rate	5.00%
Term Loan Facility [Member]
Debt Instrument
Total debt		219,964,000	219,297,000
Original issue discount		10,400,000	11,375,000
Term of debt		5 years
Outstanding principal balance under term loan facility		230,400,000
Principal payments		300,000
Debt Instrument Annual Amortization Rate (as a percent)		5.00%
Term Loan Facility [Member] | Base Rate
Debt Instrument
Debt Instrument Variable Interest Rate Floor		2.50%
Effective interest rate		10.75%
Term Loan Facility [Member] | LIBOR
Debt Instrument
Basis spread on variable rate		1.00%
Debt Instrument Variable Interest Rate Floor		1.50%
Effective interest rate		10.00%
Term Loan Facility [Member] | Federal Funds
Debt Instrument
Basis spread on variable rate		0.50%
Real Estate Bridge Loan [Member]
Debt Instrument
Total debt		360,000,000
Term of debt	24 months
Effective interest rate				7.25%
Real Estate Bridge Loan [Member] | LIBOR
Debt Instrument
Basis spread on variable rate	6.75%
Debt Instrument Variable Interest Rate Floor	0.50%
HUD Insured Loans
Debt Instrument
Total debt		100,845,000
Weighted Average Interest Rate	5.30%	4.20%
Mortgages on Entity Property (recourse)
Debt Instrument
Total debt		13,370,000	14,488,000
Mortgages on Entity Property (recourse) | Minimum
Debt Instrument
Effective interest rate		2.50%
Mortgages on Entity Property (recourse) | Maximum
Debt Instrument
Effective interest rate		21.90%
Mortgages Held by Joint Ventures (non-recourse)
Debt Instrument
Total debt		49,478,000	49,961,000
Mortgages Held by Joint Ventures (non-recourse) | Minimum
Debt Instrument
Effective interest rate		6.00%
Mortgages Held by Joint Ventures (non-recourse) | Maximum
Debt Instrument
Effective interest rate		1.90%
Revolving Credit Facility
Debt Instrument
Total debt		250,000,000	254,500,000
Line of Credit Facility, Maximum Borrowing Capacity	550,000,000
Debt Instrument Number of Tranches	3
Debt instrument maturity period if not refinanced	90 days
Outstanding borrowings under the revolving credit facilities		250,000,000
Outstanding Letters of Credit		109,200,000
Available borrowing capacity under the revolving credit facilities		$165,800,000
Revolving Credit Facility | Minimum
Debt Instrument
Commitment fee rate (as percentage)		0.38%
Revolving Credit Facility | Maximum
Debt Instrument
Commitment fee rate (as percentage)		0.50%
Revolving Credit Facility | Federal Funds
Debt Instrument
Basis spread on variable rate	3.00%

LongTerm_Debt_Bridge_HUD_and_O

Long-Term Debt - Bridge HUD and Other (Details) (USD $)	0 Months Ended	3 Months Ended
	Feb. 02, 2015	Mar. 31, 2015	Dec. 31, 2015
	item
	facility
Debt Instrument
Weighted Average Interest Rate		3.33%
Real Estate Bridge Loan [Member]
Debt Instrument
Real estate bridge loan	$360,000,000
Number of facilities pledged	67
Term of debt	24 months
Debt instrument number of term extensions	2
Debt instrument term extension period (in days)	90 days
Principal balance outstanding			360,000,000
Effective interest rate			7.25%
HUD Insured Loans
Debt Instrument
Number of facilities pledged	10
Principal balance outstanding		100,800,000
Number of debt instruments	10
Debt premium		14,900,000
Debt instrument average remaining term (in years)		33 years
Weighted Average Interest Rate	5.30%	4.20%
Debt instrument period in which prepayment is not allowed (in months)		12 months
Prepayment penalty (as a percentage)		10.00%
Decrease in prepayment penalty (as a percentage)		1.00%
HUD Insured Loans | Prepaid Expenses and Other Current Assets [Member]
Debt Instrument
Escrow reserve funds		$4,900,000
Mortgages Held by Joint Ventures (non-recourse)
Debt Instrument
Number of facilities pledged		2
Number of debt instruments		2
Maximum | HUD Insured Loans
Debt Instrument
Debt instrument average remaining term (in years)	35 years
Fixed interest rate		4.60%
Maximum | Mortgages Held by Joint Ventures (non-recourse)
Debt Instrument
Effective interest rate		1.90%
Maximum | Mortgages on Entity Property (recourse)
Debt Instrument
Effective interest rate		21.90%
Minimum | HUD Insured Loans
Debt Instrument
Debt instrument average remaining term (in years)	30 years
Fixed interest rate		3.40%
Minimum | Mortgages Held by Joint Ventures (non-recourse)
Debt Instrument
Effective interest rate		6.00%
Minimum | Mortgages on Entity Property (recourse)
Debt Instrument
Effective interest rate		2.50%
LIBOR | Real Estate Bridge Loan [Member]
Debt Instrument
Basis spread on variable rate	6.75%
Debt Instrument Variable Interest Rate Floor	0.50%
LIBOR | Maximum | Real Estate Bridge Loan [Member]
Debt Instrument
Debt instrument additional margin based on days outstanding	7.00%

LongTerm_Debt_Maturity_Details

Long-Term Debt - Maturity (Details) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Long-term Debt, Rolling Maturity [Abstract]
2016	$12,829
2017	372,972
2018	218,687
2019	13,842
2020	254,380
Thereafter	120,947
Total long-term debt	$993,657	$538,246

Lease_and_Lease_Commitments_Fu

Lease and Lease Commitments - Future Minimum Capital and Operating Lease Payments (Details) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Capital Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]
2016	$91,697
2017	93,871
2018	96,088
2019	98,455
2020	100,924
Thereafter	3,027,741
Total future minimum lease payments	3,508,776
Less amount representing interest	-2,500,217
Capital lease obligation	1,008,559
Less current portion	-3,004	-2,875
Long-term capital lease obligation	1,005,555	1,002,762
Operating Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]
2016	143,415
2017	143,002
2018	136,130
2019	132,616
2020	131,259
Thereafter	373,463
Total future minimum lease payments	$1,059,885

Lease_and_Lease_Commitments_Ca

Lease and Lease Commitments - Capital Lease Rates and Deferred Balances (Details) (USD $)	3 Months Ended
In Millions, unless otherwise specified	Mar. 31, 2015	Dec. 31, 2014
Other long-lived intangibles
Net favorable leases	64.1	$47.80
Other Noncurrent Liabilities [Member]
Net unfavorable leases	41.3	31.4
Deferred straight-line rent balances included in other long-term liabilities	21.8	$20.60
Maximum
Capital lease imputed interest rate (as a percent)	12.80%
Minimum
Capital lease imputed interest rate (as a percent)	3.50%

Financing_Obligation_Details

Financing Obligation (Details) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Present Value of Future Minimum Lease Payments, Sale Leaseback Transactions, Rolling Maturity [Abstract]
2016	$262,053
2017	270,608
2018	278,319
2019	286,253
2020	294,241
Thereafter	9,887,841
Total future minimum lease payments	11,279,315
Less amount representing interest	-8,349,219
Financing obligation	2,930,096
Less current portion	-1,098	-1,138
Long-term financing obligation	$2,928,998	$2,911,200

Income_Taxes_Details

Income Taxes (Details) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2015	Mar. 31, 2014	Feb. 02, 2015
Income tax benefit	($5,648)	($2,754)
Effective tax rate	4.60%	6.30%
Decrease in effective tax rate (as a percent)	1.70%
FC-GEN Operations Investment, LLC
Percentage of voting interests acquired			58.00%
Tax receivable agreement, potential payment as percentage of cash savings	90.00%

Commitments_and_Contingencies_

Commitments and Contingencies - Self Insurance Risks (Details) (USD $)	3 Months Ended
	Mar. 31, 2015	Mar. 31, 2014	Dec. 31, 2014
Commitments and Contingencies Disclosure [Abstract]
Workers' compensation approximate discount rate	$1
Workers' Compensation discount rate	0.80%
Effect of discounting on reserve	5,700,000		4,800,000
Provision for general and professional liability	26,200,000	22,400,000
Reserve for general and professional liability	320,500,000		288,200,000
Provision for workers' compensation	18,000,000	15,000,000
Reserve for workers' compensaton risks	$224,700,000		$198,000,000

Commitments_and_Contingencies_1

Commitments and Contingencies - Litigation (Details) (USD $)	0 Months Ended		1 Months Ended
	Aug. 06, 2014	Aug. 02, 2013	Feb. 28, 2015	Mar. 31, 2015
	item
Creekside Hospice Investigation
Loss Contingencies
Number of Qui Tam proceedings	2
Loss contingency, range of possible penalty per claim, minimum		$5,500
Loss contingency, range of possible penalty per claim, maximum		11,000
Accrued contingent liability				6,000,000
Therapy Matters Investigation [Member]
Loss Contingencies
Loss contingency, range of possible penalty per claim, minimum			5,500
Loss contingency, range of possible penalty per claim, maximum			$11,000

Fair_Value_Measurements_Fair_V

Fair Value Measurements - Fair Value Hierarchy (Details) (USD $)	Mar. 31, 2015	Dec. 31, 2014
In Thousands, unless otherwise specified
Financial Liabilities Fair Value Disclosure [Abstract]
Outstanding borrowings under the revolving credit facilities	$250,000
Carrying value	993,657	538,246
Term Loan Facility [Member]
Financial Liabilities Fair Value Disclosure [Abstract]
Carrying value	219,964	219,297
Original issue discount	10,400	11,375
Real Estate Bridge Loan [Member]
Financial Liabilities Fair Value Disclosure [Abstract]
Carrying value	360,000
HUD Insured Loans
Financial Liabilities Fair Value Disclosure [Abstract]
Carrying value	100,845
Mortgages on Entity Property (recourse)
Financial Liabilities Fair Value Disclosure [Abstract]
Carrying value	13,370	14,488
Mortgages Held by Joint Ventures (non-recourse)
Financial Liabilities Fair Value Disclosure [Abstract]
Carrying value	49,478	49,961
Level 2
Financial Liabilities Fair Value Disclosure [Abstract]
Fair Value	997,689	548,626
Level 2 | Term Loan Facility [Member]
Financial Liabilities Fair Value Disclosure [Abstract]
Fair Value	223,996	229,677
Level 2 | Real Estate Bridge Loan [Member]
Financial Liabilities Fair Value Disclosure [Abstract]
Fair Value	360,000
Level 2 | HUD Insured Loans
Financial Liabilities Fair Value Disclosure [Abstract]
Fair Value	100,845
Level 2 | Mortgages on Entity Property (recourse)
Financial Liabilities Fair Value Disclosure [Abstract]
Fair Value	13,370	14,488
Level 2 | Mortgages Held by Joint Ventures (non-recourse)
Financial Liabilities Fair Value Disclosure [Abstract]
Fair Value	49,478	49,961
Fair Value, Measurements, Recurring
Assets, Fair Value Disclosure [Abstract]
Cash and equivalents	95,708	87,548
Restricted cash and equivalents	39,134	36,390
Restricted investments in marketable securities	133,647	110,350
Total	268,489	234,288
Fair Value, Measurements, Recurring | Level 1
Assets, Fair Value Disclosure [Abstract]
Cash and equivalents	95,708	87,548
Restricted cash and equivalents	39,134	36,390
Restricted investments in marketable securities	133,647	110,350
Total	268,489	234,288
Fair Value, Measurements, Nonrecurring [Member] | Level 3
Assets, Fair Value Disclosure [Abstract]
Property and equipment, Carrying Value	3,947,941	3,493,250
Goodwill, Carrying Value	423,387	169,681
Intangible assets, Carrying Value	233,181	173,112
Revolving Credit Facility
Financial Liabilities Fair Value Disclosure [Abstract]
Outstanding borrowings under the revolving credit facilities	250,000
Carrying value	250,000	254,500
Revolving Credit Facility | Level 2
Financial Liabilities Fair Value Disclosure [Abstract]
Fair Value	$250,000	$254,500

Subsequent_Events_Details

Subsequent Events (Details) (Subsequent Events, Lease Amendment, USD $)	0 Months Ended
In Millions, unless otherwise specified	Apr. 01, 2015
	facility
Subsequent Events | Lease Amendment
Subsequent Events
Number of facilities included in one-time rent buyout	8
Exit costs related to divested facilities	$9.10
Number of facility closings allowed under option terms	6
Facility closings under option, exercise period of option	2 years
Lease extension term (in years)	2 years