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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 | 9 Months Ended | 12 Months Ended
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Oct. 01, 2018 community | Jan. 01, 2018 USD ($) community | Nov. 02, 2017 community | Nov. 01, 2017 community joint_venture | Apr. 30, 2018 USD ($) community | Mar. 31, 2018 USD ($) | Jan. 31, 2018 USD ($) community | Dec. 31, 2017 USD ($) community | Sep. 30, 2018 USD ($) community | Sep. 30, 2017 USD ($) | Sep. 30, 2018 USD ($) community | Sep. 30, 2017 USD ($) | Dec. 31, 2018 community | Dec. 31, 2017 USD ($)
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Deferred revenue |  |  |  |  |  |  |  |  |  |  | $ 3,898 | $ (1,513) |  |
Non-cash management contract termination fee |  |  |  |  |  |  |  |  |  |  | 5,649 | 0 |  |
Gain (loss) on sale of assets, net |  |  |  |  |  |  |  |  | $ 9,833 | $ (233) | 76,586 | (1,383) |  |
Gain on facility lease termination |  |  |  |  |  |  |  |  | (2,337) | (4,938) | (148,804) | (11,306) |  |
Revenue |  |  |  |  |  |  |  |  | 840,179 |  | 2,642,414 |  |  |
Cash lease payments |  |  |  |  |  |  |  |  | 73,969 | 90,303 | 250,677 | 275,506 |  |
Master Lease Transactions |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Annual rent reduction |  | $ 2,500 |  |  |  |  |  |  |  |  |  |  |  |
Number of communities with rent reduction | community |  | 2 |  |  |  |  |  |  |  |  |  |  |  |
RIDEA Ventures Restructuring |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities management is retained | community |  |  |  |  | 18 |  |  |  |  |  |  |  |  |
Reduction in lease liabilities |  |  |  |  |  |  |  |  |  |  | 9,700 |  |  |
Deferred revenue |  |  |  |  |  |  |  |  |  |  | $ 9,700 |  |  |
HCP, Inc. | Master Lease Transactions |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities acquired | community |  |  |  |  |  |  |  |  |  |  | 2 |  |  |
Payment to acquire leased assets |  |  |  |  |  |  |  |  |  |  | $ 35,400 |  |  |
Number of communities leased | community |  |  | 43 |  |  |  |  |  |  |  |  |  |  |
HCP, Inc. | RIDEA Ventures Restructuring |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities acquired | community |  |  |  |  | 3 |  | 1 |  |  |  |  |  |  |
Payments to acquire asset from joint venture |  |  |  |  | $ 207,400 |  | $ 32,100 |  |  |  |  |  |  |
Forecast | Master Lease Transactions |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community |  |  |  |  |  |  |  |  |  |  |  |  | 33 |
RIDEA Ventures | RIDEA Ventures Restructuring |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Percentage ownership |  |  |  |  |  | 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 |  |  |  |  |  |
16 Communities Disposed Of Through Lease Terminations | HCP, Inc. | Master Lease Transactions |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community |  |  |  |  |  |  |  |  |  |  | 16 |  |  |
Capital Lease Obligations |  |  |  |  |  |  |  |  | 160,800 |  | $ 160,800 |  |  |
Gain (loss) on sale of assets, net |  |  |  |  |  |  |  |  | 6,100 |  | 12,600 |  |  |
Gain on facility lease termination |  |  |  |  |  |  |  |  |  |  | 1,800 |  |  |
Assets under leases |  |  |  |  |  |  |  |  | 147,800 |  | $ 147,800 |  |  |
Number of communities previously subject to sale leaseback transactions | community |  |  |  |  |  |  |  |  |  |  | 6 |  |  |
17 Communities Disposed Of Through Lease Terminations |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Capital Lease Obligations |  |  |  |  |  |  |  |  | 217,900 |  | $ 217,900 |  |  |
Assets under leases |  |  |  |  |  |  |  |  | 185,100 |  | 185,100 |  |  |
Amount exceeding carrying value of assets under leases |  |  |  |  |  |  |  |  | 32,800 |  | $ 32,800 |  |  |
Number of communities previously subject to sale leaseback transactions | community |  |  |  |  |  |  |  |  |  |  | 14 |  |  |
Cash lease payments |  |  |  |  |  |  |  |  | $ 4,900 | 5,400 | $ 14,600 | 16,100 |  |
37 Communities Disposed Of Through Management Termination | RIDEA Ventures Restructuring |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community |  |  | 37 |  |  |  |  |  | 3 |  | 20 |  |  |
Non-cash management contract termination fee |  |  |  |  |  |  |  |  | $ 600 |  | $ 5,600 |  |  |
17 Communities Disposed Of Through Management Termination | Forecast | RIDEA Ventures Restructuring |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community |  |  |  |  |  |  |  |  |  |  |  |  | 17 |
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 |  |  |  |  |  |  |  |  | 144,631 |  | $ 462,321 |  |  |
Retirement Centers | 17 Communities Disposed Of Through Lease Terminations |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community |  |  |  |  |  |  |  |  |  |  | 3 |  |  |
Assisted Living |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Revenue |  |  |  |  |  |  |  |  | 483,125 |  | $ 1,537,432 |  |  |
Assisted Living | 17 Communities Disposed Of Through Lease Terminations |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community |  |  |  |  |  |  |  |  |  |  | 13 |  |  |
CCRCs Rental |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Revenue |  |  |  |  |  |  |  |  | 104,147 |  | $ 314,012 |  |  |
CCRCs Rental | 17 Communities Disposed Of Through Lease Terminations |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community |  |  |  |  |  |  |  |  |  |  | 1 |  |  |
Resident fees |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Revenue |  |  |  |  |  |  |  |  | 840,179 | 922,892 | $ 2,642,414 | 2,873,889 |  |
Resident fees | 17 Communities Disposed Of Through Lease Terminations |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Revenue |  |  |  |  |  |  |  |  | 14,800 | 15,100 | 44,700 | 46,000 |  |
Facility operating expense |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Costs of services |  |  |  |  |  |  |  |  | 607,076 | 650,654 | 1,866,477 | 1,967,601 |  |
Facility operating expense | 17 Communities Disposed Of Through Lease Terminations |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Costs of services |  |  |  |  |  |  |  |  | 10,700 | 10,600 | 32,100 | 30,700 |  |
Management fees |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Revenue |  |  |  |  |  |  |  |  | 18,528 | 18,138 | 54,280 | 56,474 |  |
Management fees | 17 Communities Disposed Of Through Management Termination |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Revenue |  |  |  |  |  |  |  |  | $ 1,200 | $ 1,100 | $ 3,500 | $ 3,500 |  |
Subsequent event | 17 Communities Disposed Of Through Lease Terminations | HCP, Inc. | Master Lease Transactions |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of communities disposed of | community | 17 |  |  |  |  |  |  |  |  |  |  |  |  |

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