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Acquisitions, Dispositions and Other Significant Transactions - Revenue of Disposal Groups (Details) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Resident fees	$ 1,042,044	$ 1,187,234
Communities Disposed Of Through Sale And Lease Terminations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Resident fees	3,718	123,570
Facility operating expense	3,402	84,099
Cash facility lease payments	192	33,500
Communities Disposed Of Through Sale And Lease Terminations | Independent Living
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Resident fees	0	31,629
Facility operating expense	0	18,653
Communities Disposed Of Through Sale And Lease Terminations | Assisted Living and Memory Care
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Resident fees	3,718	85,448
Facility operating expense	3,402	59,389
Communities Disposed Of Through Sale And Lease Terminations | CCRCs
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Resident fees	0	6,493
Facility operating expense	$ 0	$ 6,057

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The aggregate costs related to goods produced and sold and services rendered by an entity during the reporting period. This excludes costs incurred during the reporting period related to financial services rendered and other revenue generating activities.

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Cash payments to lessor's for use of assets under operating leases.

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