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Acquisitions, Dispositions and Other Significant Transactions - HCP Master Lease Transaction and RIDEA Ventures Restructuring (Details)
$ in Thousands
 1 Months Ended 3 Months Ended 6 Months Ended 12 Months Ended
Nov. 01, 2018
community
Jan. 01, 2018
USD ($)
community
Nov. 02, 2017
community
joint_venture
Apr. 30, 2018
USD ($)
community
Mar. 31, 2018
USD ($)
Jan. 31, 2018
USD ($)
community
Dec. 31, 2017
USD ($)
community
Jun. 30, 2018
USD ($)
community
Jun. 30, 2017
USD ($)
Jun. 30, 2018
USD ($)
community
Jun. 30, 2017
USD ($)
Dec. 31, 2018
community
Dec. 31, 2017
USD ($)
Business Acquisition [Line Items]                          
Non-cash management contract termination fee                   $ 5,076 $ 0    
Gain (loss) on sale of assets, net               $ 23,322 $ (547) 66,753 (1,150)    
Gain on facility lease termination               (146,467) (6,368) (146,467) (6,368)    
Revenue               895,969 934,070 1,802,235 1,950,997    
Cash lease payments               87,115 90,599 176,708 185,203    
Master Lease Transactions                          
Business Acquisition [Line Items]                          
Total communities disposed of | community     35                    
Annual rent reduction   $ 2,500                      
Number of communities with rent reduction | community   2                      
Deferred revenue               $ 9,700   $ 9,700      
RIDEA Ventures Restructuring                          
Business Acquisition [Line Items]                          
Number of communities management is retained | community     18                    
HCP, Inc. | Master Lease Transactions                          
Business Acquisition [Line Items]                          
Number of communities acquired | community       3   1   2   2      
Payment to acquire leased assets               $ 35,400          
Payments to acquire asset from joint venture       $ 207,400   $ 32,100              
Number of communities leased | community     43                    
RIDEA Ventures | RIDEA Ventures Restructuring                          
Business Acquisition [Line Items]                          
Percentage ownership             10.00% 10.00%   10.00%     10.00%
Number of joint ventures     2       1            
Proceeds from sale of joint venture interest         $ 62,300   $ 32,100            
Number of communities managed | community     59                    
Gain (loss) on sale of assets, net         $ 41,700   $ 7,200            
10 Communities Disposed Of Through Lease Terminations | HCP, Inc. | Master Lease Transactions                          
Business Acquisition [Line Items]                          
Number of communities disposed of | community               10          
Capital Lease Obligations               $ 93,500   $ 93,500      
Gain (loss) on sale of assets, net               6,500          
Gain on facility lease termination               1,900          
Assets under leases               $ 86,900   86,900      
Number Of Communities Previously Subject To Sale Leaseback Transactions | community               3          
23 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Capital Lease Obligations               $ 287,300   287,300      
Assets under leases               248,200   248,200      
Amount exceeding carrying value of assets under leases               39,100   $ 39,100      
Number Of Communities Previously Subject To Sale Leaseback Transactions | community                   17      
Cash lease payments               $ 7,100 7,500 $ 14,100 15,000    
23 Communities Disposed Of Through Lease Terminations | Forecast | HCP, Inc. | Master Lease Transactions                          
Business Acquisition [Line Items]                          
Number of communities disposed of | community 23                        
37 Communities Disposed Of Through Management Termination | RIDEA Ventures Restructuring                          
Business Acquisition [Line Items]                          
Number of communities disposed of | community     37         7   17      
Non-cash management contract termination fee               $ 2,800   $ 5,100      
37 Communities Disposed Of Through Management Termination | Forecast | RIDEA Ventures Restructuring                          
Business Acquisition [Line Items]                          
Number of communities disposed of | community                       20  
33 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Reduction in capital lease obligations and assets under lease                         $ 145,600
Retirement Centers                          
Business Acquisition [Line Items]                          
Revenue               159,293 162,248 $ 317,690 334,868    
Retirement Centers | 23 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Number of communities disposed of | community                   3      
Assisted Living                          
Business Acquisition [Line Items]                          
Revenue               522,027 547,430 $ 1,054,307 1,137,967    
Assisted Living | 23 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Number of communities disposed of | community                   19      
CCRCs Rental                          
Business Acquisition [Line Items]                          
Revenue               104,796 114,202 $ 209,865 256,000    
CCRCs Rental | 23 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Number of communities disposed of | community                   1      
Resident fees                          
Business Acquisition [Line Items]                          
Revenue               895,969 934,070 $ 1,802,235 1,950,997    
Resident fees | 23 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Revenue               21,500 21,800 43,500 44,700    
Facility operating                          
Business Acquisition [Line Items]                          
Costs of services               627,076 642,405 1,259,401 1,316,947    
Facility operating | 23 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Costs of services               15,300 14,500 30,700 28,900    
Management fees                          
Business Acquisition [Line Items]                          
Revenue               17,071 22,442 35,752 38,336    
Management fees | 33 Communities Disposed Of Through Lease Terminations                          
Business Acquisition [Line Items]                          
Revenue               $ 1,400 $ 1,400 $ 2,700 $ 2,700