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Segment Reporting (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 12 Months Ended
Dec. 31, 2012
Sep. 30, 2012
Jun. 30, 2012
Mar. 31, 2012
Dec. 31, 2011
Sep. 30, 2011
Jun. 30, 2011
Mar. 31, 2011
Dec. 31, 2012
item
Dec. 31, 2011
Dec. 31, 2010
Segment Reporting                      
Number of operating segments                 3    
Number of reportable segments                 2    
Revenues:                      
Rental income                 $ 460,811 $ 422,166 $ 340,113
Residents fees and services                 184,031 27,851  
Total revenues 194,164 158,633 146,972 145,073 136,603 113,700 101,162 98,552 644,842 450,017 340,113
Expenses:                      
Depreciation                 141,456 113,265 90,409
Property operating expenses                 201,263 68,967 20,169
General and administrative                 31,517 26,041 21,677
Acquisition related costs                 9,394 12,239 3,610
Impairment of assets                 3,071 1,990 5,965
Total expenses                 386,701 222,502 141,830
Operating income (loss)                 258,141 227,515 198,283
Interest and other income                 1,117 1,451 844
Interest expense                 (117,240) (98,262) (80,017)
Loss on early extinguishment of debt                 (6,349) (427) (2,433)
Gain on lease terminations                 375    
(Loss) gain on sale of properties                 (101) 21,315 109
Equity in earnings (losses) of an investee                 316 139 (1)
Income before income tax expense                 136,259 151,731 116,785
Income tax expense                 (375) (312) (300)
Net income 44,636 25,646 33,251 32,352 38,599 29,996 51,048 31,776 135,884 151,419 116,485
Total assets 4,748,002       4,383,048       4,748,002 4,383,048  
Short and Long Term Residential Care Communities
                      
Revenues:                      
Rental income                 246,948 242,652 237,578
Residents fees and services                 184,031 27,851  
Total revenues                 430,979 270,503 237,578
Expenses:                      
Depreciation                 87,856 71,020 66,172
Property operating expenses                 138,819 21,639  
Impairment of assets                   1,028 1,095
Total expenses                 226,675 93,687 67,267
Operating income (loss)                 204,304 176,816 170,311
Interest expense                 (47,299) (43,862) (41,076)
Gain on lease terminations                 375    
(Loss) gain on sale of properties                   21,236 109
Income before income tax expense                 157,380 154,190 129,344
Net income                 157,380 154,190 129,344
Total assets 2,767,227       2,461,532       2,767,227 2,461,532 1,905,938
MOBs
                      
Revenues:                      
Rental income                 196,107 161,809 85,152
Total revenues                 196,107 161,809 85,152
Expenses:                      
Depreciation                 49,808 38,453 20,445
Property operating expenses                 62,444 47,328 20,169
Impairment of assets                 3,071 962 4,870
Total expenses                 115,323 86,743 45,484
Operating income (loss)                 80,784 75,066 39,668
Interest expense                 (3,255) (996) (862)
(Loss) gain on sale of properties                 (101) 79  
Income before income tax expense                 77,428 74,149 38,806
Net income                 77,428 74,149 38,806
Total assets 1,684,434       1,487,364       1,684,434 1,487,364 1,167,994
All Other Operations
                      
Revenues:                      
Rental income                 17,756 17,705 17,383
Total revenues                 17,756 17,705 17,383
Expenses:                      
Depreciation                 3,792 3,792 3,792
General and administrative                 31,517 26,041 21,677
Acquisition related costs                 9,394 12,239 3,610
Total expenses                 44,703 42,072 29,079
Operating income (loss)                 (26,947) (24,367) (11,696)
Interest and other income                 1,117 1,451 844
Interest expense                 (66,686) (53,404) (38,079)
Loss on early extinguishment of debt                 (6,349) (427) (2,433)
Equity in earnings (losses) of an investee                 316 139 (1)
Income before income tax expense                 (98,549) (76,608) (51,365)
Income tax expense                 (375) (312) (300)
Net income                 (98,924) (76,920) (51,665)
Total assets 296,341       434,152       296,341 434,152 318,724
Consolidated
                      
Revenues:                      
Rental income                 460,811 422,166 340,113
Residents fees and services                 184,031 27,851  
Total revenues                 644,842 450,017 340,113
Expenses:                      
Depreciation                 141,456 113,265 90,409
Property operating expenses                 201,263 68,967 20,169
General and administrative                 31,517 26,041 21,677
Acquisition related costs                 9,394 12,239 3,610
Impairment of assets                 3,071 1,990 5,965
Total expenses                 386,701 222,502 141,830
Operating income (loss)                 258,141 227,515 198,283
Interest and other income                 1,117 1,451 844
Interest expense                 (117,240) (98,262) (80,017)
Loss on early extinguishment of debt                 (6,349) (427) (2,433)
Gain on lease terminations                 375    
(Loss) gain on sale of properties                 (101) 21,315 109
Equity in earnings (losses) of an investee                 316 139 (1)
Income before income tax expense                 136,259 151,731 116,785
Income tax expense                 (375) (312) (300)
Net income                 135,884 151,419 116,485
Total assets $ 4,748,002       $ 4,383,048       $ 4,748,002 $ 4,383,048 $ 3,392,656