Real Estate Investments - Property Sales (Details) $ in Thousands	12 Months Ended
Dec. 31, 2018 USD ($) item property	Dec. 31, 2017 USD ($) item property	Dec. 31, 2016 USD ($) item property
Disposals and other
Carrying value	$ 1,106,581	$ 1,086,089
Proceeds from sale of real estate, net	92,749	15,413	$ 17,369
Net Gain (Loss)	70,682	3,814	3,582
Impairment charges		1,880	766
Properties sold
Disposals and other
Carrying value	22,393	11,277	13,789
Sales price	$ 95,825	$ 15,650	$ 17,450
Number of beds or units in property sold \| item	774	296	409
Number of properties sold \| property	10	6	5
Net Gain (Loss)	$ 70,682	$ 3,814	$ 3,582
Properties sold \| ALF
Disposals and other
Carrying value	16,352
Sales price	$ 67,500
Number of beds or units in property sold \| item	320
Number of properties sold \| property	6
Net Gain (Loss)	$ 48,695
Properties sold \| ALF \| Florida
Disposals and other
Carrying value			4,869
Sales price			$ 6,850
Number of beds or units in property sold \| item			174
Number of properties sold \| property			2
Net Gain (Loss)			$ 1,973
Properties sold \| ALF \| Kansas
Disposals and other
Carrying value	346
Sales price	350
Properties sold \| ALF \| Indiana and Iowa
Disposals and other
Carrying value		10,107
Sales price		$ 15,650
Number of beds or units in property sold \| item		211
Number of properties sold \| property		5
Net Gain (Loss)		$ 4,985
Properties sold \| SNF \| Alabama
Disposals and other
Carrying value	5,695
Sales price	$ 27,975
Number of beds or units in property sold \| item	454
Number of properties sold \| property	4
Net Gain (Loss)	$ 21,987
Properties sold \| SNF \| Texas
Disposals and other
Carrying value		$ 1,170	4,923
Sales price			$ 6,750
Number of beds or units in property sold \| item		85	235
Number of properties sold \| property		1	2
Net Gain (Loss)		$ (1,171)	$ 1,802
Properties sold \| OTH \| New Jersey
Disposals and other
Carrying value			3,997
Sales price			$ 3,850
Number of properties sold \| property			1
Net Gain (Loss)			$ (193)

The number of beds or units in a real estate property sold by the entity.

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- Definition

The number of real estate properties sold by the entity.

+ References

No definition available.

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- Definition

Sales price of real estate or properties that were intended to be sold or held for capital appreciation or rental income.

+ References

No definition available.

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- Definition

The difference between the carrying value and the sale price of real estate or properties that were intended to be sold or held for capital appreciation or rental income. This element refers to the gain (loss) included in earnings and not to the cash proceeds of the sale. This element is a noncash adjustment to net income when calculating net cash generated by operating activities using the indirect method.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
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-Section 45
-Paragraph 28
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-URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 45
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=109226348&loc=d3e2443-110228

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- Definition

The charge against earnings in the period to reduce the carrying amount of real property to fair value.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 28
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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-URI http://asc.fasb.org/extlink&oid=109226691&loc=d3e2921-110230

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- Definition

Cash received from the sale of real estate that is held for investment, that is, it is part of an investing activity during the period.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 12
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-URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3179-108585

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- References

No definition available.

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- Definition

Amount of real estate investment property, net of accumulated depreciation, which may include the following: (1) land available-for-sale; (2) land available-for-development; (3) investments in building and building improvements; (4) tenant allowances; (5) developments in-process; (6) rental properties; and (7) other real estate investments.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
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