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CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
 12 Months Ended
Dec. 31, 2012
Dec. 31, 2011
Dec. 31, 2010
Cash flows from operating activities:      
Net income $ 135,884 $ 151,419 $ 116,485
Adjustments to reconcile net income to cash provided by operating activities:      
Depreciation 141,456 113,265 90,409
Net amortization of debt discounts, premiums and deferred financing fees 5,327 5,067 2,496
Straight line rental income (13,849) (11,457) (6,093)
Amortization of acquired real estate leases and other intangible assets 1,597 (93) 891
Loss on early extinguishment of debt 6,349 427 2,433
Impairment of assets 3,071 1,990 5,965
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
Change in assets and liabilities:      
Restricted cash (2,304) (2,134) (772)
Other assets 991 (7,341) (4,639)
Accrued interest (6,524) 7,288 1,300
Other liabilities 11,894 17,259 5,432
Cash provided by operating activities 283,302 254,236 213,799
Cash flows from investing activities:      
Real estate acquisitions and deposits (316,769) (797,113) (431,497)
Real estate improvements (50,131) (39,309) (34,438)
Loan receivable   (80,000)  
Principal payments on loan receivable 38,000 42,000  
Investment in Five Star Quality Care, Inc.   (5,000)  
Investment in Affiliates Insurance Company     (76)
Proceeds from sale of properties 1,041 38,663 1,450
Cash used for investing activities (327,859) (840,759) (464,561)
Cash flows from financing activities:      
Proceeds from issuance of common shares, net 287,052 432,233 281,986
Proceeds from issuance of unsecured senior notes, net of discount 350,000 541,984 197,852
Proceeds from borrowings on revolving credit facility 669,000 690,000 461,000
Repayments of borrowings on revolving credit facility (479,000) (818,000) (393,000)
Redemption of senior notes (225,000)   (98,780)
Repayment of other debt (266,528) (9,711) (8,506)
Payment of deferred financing fees (12,608) (13,760) (4,661)
Distributions to shareholders (259,537) (223,529) (184,757)
Cash provided by financing activities 63,379 599,217 251,134
Increase in cash and cash equivalents 18,822 12,694 372
Cash and cash equivalents at beginning of period 23,560 10,866 10,494
Cash and cash equivalents at end of period 42,382 23,560 10,866
SUPPLEMENTAL CASH FLOW INFORMATION:      
Interest paid 118,437 85,907 76,221
Income taxes paid 389 264 259
NON-CASH INVESTING ACTIVITIES:      
Acquisitions funded by assumed debt (121,793) (217,317) (2,458)
NON-CASH FINANCING ACTIVITIES:      
Assumption of mortgage notes payable 121,793 217,317 2,458
Issuance of common shares $ 2,229 $ 1,814 $ 2,058