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Revenue - Disaggregation of Revenue (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Disaggregation of Revenue [Line Items] |  |  |
Revenue | $ 2,758,259 | $ 3,540,195 | $ 4,057,088
Resident fees |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 2,543,848 | 2,892,567 | 3,209,931
Private pay |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 2,208,910 | 2,368,295 | 2,572,426
Government reimbursement |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 261,376 | 418,629 | 509,037
Other third-party payor programs |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 73,562 | 105,643 | 128,468
Independent Living | Resident fees |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 475,538 | 512,598 | 544,558
Independent Living | Private pay |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 473,740 | 510,254 | 542,112
Independent Living | Government reimbursement |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 1,798 | 2,344 | 2,446
Independent Living | 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 | 1,589,721 | 1,691,276 | 1,815,938
Assisted Living and Memory Care | Private pay |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 1,521,588 | 1,622,117 | 1,748,364
Assisted Living and Memory Care | Government reimbursement |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 68,133 | 69,159 | 67,574
Assisted Living and Memory Care | Other third-party payor programs |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 0 | 0 | 0
CCRCs | Resident fees |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 304,425 | 321,883 | 402,175
CCRCs | Private pay |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 212,981 | 235,018 | 281,197
CCRCs | Government reimbursement |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 57,362 | 59,614 | 81,054
CCRCs | Other third-party payor programs |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 34,082 | 27,251 | 39,924
Health Care Services | Resident fees |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 174,164 | 366,810 | 447,260
Health Care Services | Private pay |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 601 | 906 | 753
Health Care Services | Government reimbursement |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | 134,083 | 287,512 | 357,963
Health Care Services | Other third-party payor programs |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Revenue | $ 39,480 | $ 78,392 | $ 88,544

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