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Supplemental Disclosure of Cash Flow Information - Supplemental Disclosure of Cash Flow Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Supplemental Cash Flow Information [Abstract]      
Interest paid $ 204,696 $ 244,469 $ 260,706
Income taxes paid, net of refunds 8,878 1,534 2,058
Capital expenditures, net of related payables 185,871 304,092 225,473
Loss (gain) on debt modification and extinguishment, net 10,896 (5,247) (11,677)
Investments in unconsolidated ventures (4,082) (4,346) (9,124)
Loss (gain) on sale of assets, net (374,532) (7,245) (293,246)
Proceeds from sale of other assets, net:      
Prepaid expenses and other assets, net 24,707 55,873 26,762
Loss (gain) on sale of assets, net (374,532) (7,245) (293,246)
Loss (gain) on facility lease termination and modification, net (2,303) 3,388 162,001
Net cash paid 0 0 12,548
Capital expenditures, net of related payables:      
Supplemental Cash Flow Information [Abstract]      
Capital expenditures, net of related payables 185,871 304,092 225,473
Trade accounts payable 4,766 8,891 4,663
Acquisition of communities from Healthpeak:      
Supplemental Cash Flow Information [Abstract]      
Property, plant and equipment and leasehold intangibles, net 286,734 0 0
Operating lease right-of-use assets (63,285) 0 0
Financing lease obligations 129,196 0 0
Operating lease obligations 74,335 0 0
Loss (gain) on debt modification and extinguishment, net (19,731) 0 0
Net cash paid 407,249 0 0
Proceeds from sale of other assets, net:      
Property, plant and equipment and leasehold intangibles, net 286,734 0 0
Master Agreement with Ventas:      
Supplemental Cash Flow Information [Abstract]      
Property, plant and equipment and leasehold intangibles, net (66,444) 0 0
Operating lease right-of-use assets (153,213) 0 0
Financing lease obligations 7,077 0 0
Operating lease obligations 362,944 0 0
Net cash paid 119,180 0 0
Other assets, net (42,354) 0 0
Long-term debt 34,053 0 0
Additional paid-in-capital (22,883) 0 0
Proceeds from sale of other assets, net:      
Property, plant and equipment and leasehold intangibles, net (66,444) 0 0
Acquisition of other assets, net of related payables and cash received:      
Supplemental Cash Flow Information [Abstract]      
Property, plant and equipment and leasehold intangibles, net 684 44 237,563
Net cash paid 64,944 497 271,771
Other intangible assets, net 0 453 4,345
Other liabilities 0 0 2,433
Proceeds from sale of other assets, net:      
Property, plant and equipment and leasehold intangibles, net 684 44 237,563
Financing lease obligations 64,260 0 36,120
Proceeds from sale of CCRC Venture, net:      
Supplemental Cash Flow Information [Abstract]      
Investments in unconsolidated ventures (14,848) 0 0
Current portion of long-term debt 34,706 0 0
Other liabilities 60,748 0 0
Loss (gain) on sale of assets, net 369,831 0 0
Net cash received (289,225) 0 0
Proceeds from sale of other assets, net:      
Other liabilities 60,748 0 0
Loss (gain) on sale of assets, net 369,831 0 0
Proceeds from sale of other assets, net:      
Supplemental Cash Flow Information [Abstract]      
Property, plant and equipment and leasehold intangibles, net (938) (379) (93,098)
Other liabilities (786) (1,479) 1,139
Loss (gain) on sale of assets, net (4,701) (7,245) (249,754)
Proceeds from sale of other assets, net:      
Prepaid expenses and other assets, net (1,318) (4,422) (4,950)
Assets held for sale 34,348 79,054 197,111
Property, plant and equipment and leasehold intangibles, net (938) (379) (93,098)
Investments in unconsolidated ventures 0 (156) (58,179)
Financing lease obligations 0 0 93,514
Refundable fees and deferred revenue 0 0 8,632
Other liabilities (786) (1,479) 1,139
Loss (gain) on sale of assets, net (4,701) (7,245) (249,754)
Net cash received (42,091) (92,735) (499,807)
Lease termination and modification, net      
Supplemental Cash Flow Information [Abstract]      
Property, plant and equipment and leasehold intangibles, net 0 0 (87,464)
Loss (gain) on sale of assets, net 0 0 (5,761)
Proceeds from sale of other assets, net:      
Prepaid expenses and other assets, net 0 0 (2,804)
Property, plant and equipment and leasehold intangibles, net 0 0 (87,464)
Loss (gain) on sale of assets, net 0 0 (5,761)
Loss (gain) on facility lease termination and modification, net 0 0 34,283
Financing lease right-of-use assets 0 0 58,099
Deferred liabilities 0 0 70,835
Net cash paid 0 0 67,188
Non-Development | Capital expenditures, net of related payables:      
Supplemental Cash Flow Information [Abstract]      
Capital expenditures, net of related payables 139,592 235,797 182,249
Development | Capital expenditures, net of related payables:      
Supplemental Cash Flow Information [Abstract]      
Capital expenditures, net of related payables 13,667 24,595 24,687
Non-development - Reimbursable | Capital expenditures, net of related payables:      
Supplemental Cash Flow Information [Abstract]      
Capital expenditures, net of related payables 27,846 34,809 12,165
Development - Reimbursable | Capital expenditures, net of related payables:      
Supplemental Cash Flow Information [Abstract]      
Capital expenditures, net of related payables $ 0 $ 0 $ 1,709