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Segment Reporting (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 12 Months Ended
Dec. 31, 2011
Sep. 30, 2011
Jun. 30, 2011
Mar. 31, 2011
Dec. 31, 2010
Sep. 30, 2010
Jun. 30, 2010
Mar. 31, 2010
Dec. 31, 2011
segment
Dec. 31, 2010
Dec. 31, 2009
Segment Reporting                      
Number of operating segments                 3    
Number of reportable segments                 2    
Revenues:                      
Rental income                 $ 422,166 $ 340,113 $ 297,399
Residents fees and services                 27,851    
Total revenues 136,603 113,277 100,748 98,077 97,295 81,164 81,008 80,704 450,017 340,113 297,399
Expenses:                      
Depreciation                 113,265 90,409 78,583
Property operating expenses                 68,967 20,169 14,901
General and administrative                 26,041 21,677 19,825
Acquisition related costs                 12,239 3,610 3,327
Impairment of assets                 1,990 5,965 15,530
Total expenses                 222,502 141,830 132,166
Operating income (loss)                 227,515 198,283 165,233
Interest and other income                 1,451 844 935
Interest expense                 (98,262) (80,017) (56,404)
Loss on early extinguishment of debt                 (427) (2,433)  
Gain on sale of properties                 21,315 109 397
Equity in earnings of an investee                 139 (1) (134)
Income before income tax expense                 151,731 116,785 110,027
Income tax expense                 (312) (300) (312)
Net income 38,599 29,996 51,048 31,776 33,864 28,078 24,559 29,984 151,419 116,485 109,715
Total assets 4,383,048       3,392,656       4,383,048 3,392,656 2,987,926
Short and Long Term Residential Care Communities
                      
Revenues:                      
Rental income                 242,652 237,578 226,247
Residents fees and services                 27,851    
Total revenues                 270,503 237,578 226,247
Expenses:                      
Depreciation                 71,020 66,172 61,122
Property operating expenses                 21,639    
Impairment of assets                 1,028 1,095 3,784
Total expenses                 93,687 67,267 64,906
Operating income (loss)                 176,816 170,311 161,341
Interest expense                 (43,862) (41,076) (21,297)
Gain on sale of properties                 21,236 109 397
Income before income tax expense                 154,190 129,344 140,441
Net income                 154,190 129,344 140,441
Total assets 2,461,532       1,905,938       2,461,532 1,905,938 1,972,435
MOB
                      
Revenues:                      
Rental income                 161,809 85,152 53,862
Total revenues                 161,809 85,152 53,862
Expenses:                      
Depreciation                 38,453 20,445 13,669
Property operating expenses                 47,328 20,169 14,901
Impairment of assets                 962 4,870 11,746
Total expenses                 86,743 45,484 40,316
Operating income (loss)                 75,066 39,668 13,546
Interest expense                 (996) (862) (743)
Gain on sale of properties                 79    
Income before income tax expense                 74,149 38,806 12,803
Net income                 74,149 38,806 12,803
Total assets 1,487,364       1,167,994       1,487,364 1,167,994 738,093
All Other Operations
                      
Revenues:                      
Rental income                 17,705 17,383 17,290
Total revenues                 17,705 17,383 17,290
Expenses:                      
Depreciation                 3,792 3,792 3,792
General and administrative                 26,041 21,677 19,825
Acquisition related costs                 12,239 3,610 3,327
Total expenses                 42,072 29,079 26,944
Operating income (loss)                 (24,367) (11,696) (9,654)
Interest and other income                 1,451 844 935
Interest expense                 (53,404) (38,079) (34,364)
Loss on early extinguishment of debt                 (427) (2,433)  
Equity in earnings of an investee                 139 (1) (134)
Income before income tax expense                 (76,608) (51,365) (43,217)
Income tax expense                 (312) (300) (312)
Net income                 (76,920) (51,665) (43,529)
Total assets $ 434,152       $ 318,724       $ 434,152 $ 318,724 $ 277,398