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Revenue - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Disaggregation of Revenue [Line Items]
Revenue	$ 807,980	$ 1,008,949	$ 2,688,028	$ 3,070,450
Private pay
Disaggregation of Revenue [Line Items]
Revenue	573,798	642,165	1,818,766	1,931,066
Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	102,544	126,795	315,866	383,252
Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	24,429	32,277	80,475	98,261
Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	700,771	801,237	2,215,107	2,412,579
Independent Living | Private pay
Disaggregation of Revenue [Line Items]
Revenue	125,156	136,274	390,124	406,667
Independent Living | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	606	600	1,778	1,852
Independent Living | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	0	0	0	0
Independent Living | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	125,762	136,874	391,902	408,519
Assisted Living and Memory Care | Private pay
Disaggregation of Revenue [Line Items]
Revenue	391,292	435,367	1,246,181	1,310,867
Assisted Living and Memory Care | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	17,403	17,107	52,149	50,358
Assisted Living and Memory Care | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	0	0	0	0
Assisted Living and Memory Care | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	408,695	452,474	1,298,330	1,361,225
CCRCs | Private pay
Disaggregation of Revenue [Line Items]
Revenue	57,129	70,353	181,812	212,978
CCRCs | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	13,440	19,931	46,589	61,614
CCRCs | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	5,842	9,820	21,582	30,492
CCRCs | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	76,411	100,104	249,983	305,084
Health Care Services | Private pay
Disaggregation of Revenue [Line Items]
Revenue	221	171	649	554
Health Care Services | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	71,095	89,157	215,350	269,428
Health Care Services | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	18,587	22,457	58,893	67,769
Health Care Services | Total resident fee revenue
Disaggregation of Revenue [Line Items]
Revenue	$ 89,903	$ 111,785	$ 274,892	$ 337,751

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