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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, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Supplemental Cash Flow Information [Abstract] |  |  |
Interest paid | $ 188,791 | $ 204,696 | $ 244,469
Income taxes paid, net of refunds | 5,923 | 8,878 | 1,534
Capital expenditures, net of related payables | 176,657 | 185,871 | 304,092
Loss (gain) on debt modification and extinguishment, net | (1,932) | 10,896 | (5,247)
Accounts receivable, net | (502) | (24,277) | (292)
Investments in unconsolidated ventures | 5,436 | 4,082 | 4,346
Prepaid expenses and other assets, net | (15,483) | 24,707 | 55,873
Refundable fees and deferred revenue | (10,066) | 62,614 | (25,117)
Loss (gain) on sale of assets, net | (288,835) | (374,532) | (7,245)
Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | 176,657 | 185,871 | 304,092
Trade accounts payable | (6,061) | 4,766 | 8,891
Acquisition of communities from Healthpeak: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Property, plant and equipment and leasehold intangibles, net | 0 | 286,734 | 0
Operating lease right-of-use assets | 0 | (63,285) | 0
Financing lease obligations | 0 | 129,196 | 0
Operating lease obligations | 0 | 74,335 | 0
Loss (gain) on debt modification and extinguishment, net | 0 | (19,731) | 0
Net cash paid | 0 | 407,249 | 0
Master Agreement with Ventas: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Property, plant and equipment and leasehold intangibles, net | 0 | (66,444) | 0
Operating lease right-of-use assets | 0 | (153,213) | 0
Financing lease obligations | 0 | 7,077 | 0
Operating lease obligations | 0 | 362,944 | 0
Net cash paid | 0 | 119,180 | 0
Other assets, net | 0 | (42,354) | 0
Long-term debt | 0 | 34,053 | 0
Additional paid-in-capital | 0 | (22,883) | 0
Proceeds from HCS Sale, net: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Trade accounts payable | 1,387 | 0 | 0
Property, plant and equipment and leasehold intangibles, net | (1,806) | 0 | 0
Operating lease right-of-use assets | (8,145) | 0 | 0
Operating lease obligations | 8,145 | 0 | 0
Accounts receivable, net | (57,582) | 0 | 0
Investments in unconsolidated ventures | 100,000 | 0 | 0
Goodwill | (126,810) | 0 | 0
Prepaid expenses and other assets, net | (32,963) | 0 | 0
Accrued expenses | 25,226 | 0 | 0
Refundable fees and deferred revenue | 57,314 | 0 | 0
Other liabilities | 9,165 | 0 | 0
Loss (gain) on sale of assets, net | (286,489) | 0 | 0
Net cash received | (312,558) | 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 | 0 | 684 | 44
Financing lease obligations | 0 | 64,260 | 0
Net cash paid | 0 | 64,944 | 497
Other intangible assets, net | 0 | 0 | 453
Proceeds from sale of CCRC Venture, net: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Investments in unconsolidated ventures | 0 | 14,848 | 0
Other liabilities | 0 | 60,748 | 0
Loss (gain) on sale of assets, net | 0 | (369,831) | 0
Current portion of long-term debt | 0 | 34,706 | 0
Net cash received | 0 | (289,225) | 0
Proceeds from sale of other assets, net: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Property, plant and equipment and leasehold intangibles, net | (878) | (938) | (379)
Prepaid expenses and other assets, net | (1,983) | (1,318) | (4,422)
Other liabilities | 75 | 786 | 1,479
Loss (gain) on sale of assets, net | (2,346) | (4,701) | (7,245)
Assets held for sale | (16,166) | (34,348) | (79,054)
Investments in unconsolidated ventures | 0 | 0 | (156)
Net cash received | (21,448) | (42,091) | (92,735)
Non-Development | Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | 137,410 | 139,592 | 235,797
Development | Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | 3,208 | 13,667 | 24,595
Non-development - Reimbursable | Capital expenditures, net of related payables: |  |  |
Supplemental Cash Flow Information [Abstract] |  |  |
Capital expenditures, net of related payables | $ 42,100 | $ 27,846 | $ 34,809

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