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Revenue - Disaggregation of Revenue (Details) - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2020 | Mar. 31, 2019
Disaggregation of Revenue [Line Items] |  |
Revenue | $ 1,014,139 | $ 1,042,044
Private pay |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 640,776 | 648,679
Government reimbursement |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 110,532 | 127,408
Other third-party payor programs |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 31,399 | 33,392
Total resident fee revenue |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 782,707 | 809,479
Independent Living | Private pay |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 135,290 | 135,045
Independent Living | Government reimbursement |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 572 | 649
Independent Living | Other third-party payor programs |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 0 | 0
Independent Living | Total resident fee revenue |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 135,862 | 135,694
Assisted Living and Memory Care | Private pay |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 440,613 | 441,911
Assisted Living and Memory Care | Government reimbursement |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 16,866 | 16,615
Assisted Living and Memory Care | Other third-party payor programs |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 0 | 0
Assisted Living and Memory Care | Total resident fee revenue |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 457,479 | 458,526
CCRCs | Private pay |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 64,703 | 71,533
CCRCs | Government reimbursement |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 19,405 | 21,487
CCRCs | Other third-party payor programs |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 10,439 | 10,707
CCRCs | Total resident fee revenue |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 94,547 | 103,727
Health Care Services | Private pay |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 170 | 190
Health Care Services | Government reimbursement |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 73,689 | 88,657
Health Care Services | Other third-party payor programs |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | 20,960 | 22,685
Health Care Services | Total resident fee revenue |  |
Disaggregation of Revenue [Line Items] |  |
Revenue | $ 94,819 | $ 111,532

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