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Revenue - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Disaggregation of Revenue [Line Items]
Revenue	$ 3,540,195	$ 4,057,088	$ 4,531,426
Private pay
Disaggregation of Revenue [Line Items]
Revenue	2,368,295	2,572,426	2,809,903
Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	418,629	509,037	522,209
Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	105,643	128,468	117,099
Resident fees
Disaggregation of Revenue [Line Items]
Revenue	2,892,567	3,209,931	3,449,211
Independent Living | Private pay
Disaggregation of Revenue [Line Items]
Revenue	510,254	542,112	596,852
Independent Living | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	2,344	2,446	3,125
Independent Living | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	0	0	0
Independent Living | Resident fees
Disaggregation of Revenue [Line Items]
Revenue	512,598	544,558	599,977
Assisted Living and Memory Care | Private pay
Disaggregation of Revenue [Line Items]
Revenue	1,622,117	1,748,364	1,923,676
Assisted Living and Memory Care | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	69,159	67,574	72,175
Assisted Living and Memory Care | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	0	0	0
Assisted Living and Memory Care | Resident fees
Disaggregation of Revenue [Line Items]
Revenue	1,691,276	1,815,938	1,995,851
CCRCs | Private pay
Disaggregation of Revenue [Line Items]
Revenue	235,018	281,197	288,682
CCRCs | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	59,614	81,054	87,028
CCRCs | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	27,251	39,924	40,698
CCRCs | Resident fees
Disaggregation of Revenue [Line Items]
Revenue	321,883	402,175	416,408
Health Care Services | Private pay
Disaggregation of Revenue [Line Items]
Revenue	906	753	693
Health Care Services | Government reimbursement
Disaggregation of Revenue [Line Items]
Revenue	287,512	357,963	359,881
Health Care Services | Other third-party payor programs
Disaggregation of Revenue [Line Items]
Revenue	78,392	88,544	76,401
Health Care Services | Resident fees
Disaggregation of Revenue [Line Items]
Revenue	$ 366,810	$ 447,260	$ 436,975

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Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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