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Real Estate Investments - Development and Improvement Projects (Details) - Real Estate Investment Completed Projects $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($) item property	Dec. 31, 2017 USD ($) item property	Dec. 31, 2016 USD ($) item property
Completed development and improvement projects
Number of Properties | property	1	1	7
Number of Beds/Units | item	66	66	611
Total Investment | $	$ 14,998	$ 13,498	$ 81,561
ALF and MC | Developments | South Carolina
Completed development and improvement projects
Number of Properties | property			1
Number of Beds/Units | item			89
Total Investment | $			$ 15,080
ILF | Developments | Kansas
Completed development and improvement projects
Number of Properties | property			1
Number of Beds/Units | item			108
Total Investment | $			$ 13,423
SNF | Improvements | Arizona
Completed development and improvement projects
Number of Properties | property			1
Number of Beds/Units | item			160
Total Investment | $			$ 4,672
MC Units | Developments | Illinois
Completed development and improvement projects
Number of Properties | property	1	1
Number of Beds/Units | item	66	66
Total Investment | $	$ 14,998	$ 13,498
MC Units | Developments | Texas
Completed development and improvement projects
Number of Properties | property			1
Number of Beds/Units | item			56
Total Investment | $			$ 11,776
MC Units | Developments | California
Completed development and improvement projects
Number of Properties | property			1
Number of Beds/Units | item			66
Total Investment | $			$ 12,400
MC Units | Developments | Real Estate Development Commitments, Commitments One | Illinois
Completed development and improvement projects
Number of Properties | property			1
Number of Beds/Units | item			66
Total Investment | $			$ 12,248
MC Units | Developments | Real Estate Development Commitments, Commitments Two | Illinois
Completed development and improvement projects
Number of Properties | property			1
Number of Beds/Units | item			66
Total Investment | $			$ 11,962

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