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Segment Reporting (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 12 Months Ended
Dec. 31, 2013
Sep. 30, 2013
Jun. 30, 2013
Mar. 31, 2013
Dec. 31, 2012
Sep. 30, 2012
Jun. 30, 2012
Mar. 31, 2012
Dec. 31, 2013
item
Dec. 31, 2012
Dec. 31, 2011
Segment Reporting                      
Number of operating segments                 4    
Number of reportable segments                 3    
Revenues:                      
Rental income                 $ 459,380 $ 450,769 $ 412,180
Residents fees and services                 302,058 184,031 27,851
Total revenues 200,336 187,265 186,928 186,909 191,703 156,108 144,393 142,596 761,438 634,800 440,031
Expenses:                      
Property operating expenses                 299,878 197,696 65,400
Depreciation                 153,026 139,042 110,959
General and administrative                 32,657 31,517 26,041
Acquisition related costs                 3,378 9,394 12,239
Impairment of assets     32,267           7,989 3,071 1,990
Total expenses                 496,928 380,720 216,629
Operating income                 264,510 254,080 223,402
Interest and other income                 711 1,117 1,451
Interest expense                 (117,819) (117,240) (98,262)
Loss on early extinguishment of debt                 (797) (6,349) (427)
Gain on lease terminations                   375  
Income from continuing operations before income tax expense and equity in earnings of an investee                 146,605 131,983 126,164
Income tax expense                 (600) (375) (312)
Equity in earnings of an investee                 334 316 139
Income from continuing operations                 146,339 131,924 125,991
Discontinued Operations:                      
Income from discontinued operations                 5,043 4,061 4,113
Impairment of assets from discontinued operations                 (37,610)    
Income before gain (loss) on sale of properties                 113,772 135,985 130,104
Gain (loss) on sale of properties                 37,392 (101) 21,315
Net income 72,206 38,125 5,598 35,235 44,636 25,646 33,251 32,352 151,164 135,884 151,419
Total assets 4,764,666       4,748,002       4,764,666 4,748,002 4,383,048
Triple Net Senior Living Communities
                      
Revenues:                      
Rental income                 237,209 246,948 242,652
Total revenues                 237,209 246,948 242,652
Expenses:                      
Depreciation                 66,854 68,419 68,429
Impairment of assets                 6,685   1,028
Total expenses                 73,539 68,419 69,457
Operating income                 163,670 178,529 173,195
Interest expense                 (26,501) (35,530) (41,510)
Gain on lease terminations                   375  
Income from continuing operations before income tax expense and equity in earnings of an investee                 137,169 143,374 131,685
Income from continuing operations                 137,169 143,374 131,685
Discontinued Operations:                      
Income before gain (loss) on sale of properties                 137,169 143,374 131,685
Gain (loss) on sale of properties                 37,392   21,236
Net income                 174,561 143,374 152,921
Total assets 1,778,591       1,817,253       1,778,591 1,817,253 1,818,469
Managed Senior Living Communities
                      
Revenues:                      
Residents fees and services                 302,058 184,031 27,851
Total revenues                 302,058 184,031 27,851
Expenses:                      
Property operating expenses                 233,711 138,819 21,639
Depreciation                 28,972 19,437 2,591
Total expenses                 262,683 158,256 24,230
Operating income                 39,375 25,775 3,621
Interest expense                 (12,217) (11,769) (2,352)
Income from continuing operations before income tax expense and equity in earnings of an investee                 27,158 14,006 1,269
Income from continuing operations                 27,158 14,006 1,269
Discontinued Operations:                      
Income before gain (loss) on sale of properties                 27,158 14,006 1,269
Net income                 27,158 14,006 1,269
Total assets 979,152       949,974       979,152 949,974 643,063
MOBs
                      
Revenues:                      
Rental income                 204,594 186,065 151,823
Total revenues                 204,594 186,065 151,823
Expenses:                      
Property operating expenses                 66,167 58,877 43,761
Depreciation                 53,408 47,394 36,147
Impairment of assets                   3,071 962
Total expenses                 119,575 109,342 80,870
Operating income                 85,019 76,723 70,953
Interest expense                 (5,466) (3,255) (996)
Income from continuing operations before income tax expense and equity in earnings of an investee                 79,553 73,468 69,957
Income from continuing operations                 79,553 73,468 69,957
Discontinued Operations:                      
Income from discontinued operations                 5,043 4,061 4,113
Impairment of assets from discontinued operations                 (37,610)    
Income before gain (loss) on sale of properties                 46,986 77,529 74,070
Gain (loss) on sale of properties                   (101) 79
Net income                 46,986 77,428 74,149
Total assets 1,727,497       1,684,434       1,727,497 1,684,434 1,487,364
All Other Operations
                      
Revenues:                      
Rental income                 17,577 17,756 17,705
Total revenues                 17,577 17,756 17,705
Expenses:                      
Depreciation                 3,792 3,792 3,792
General and administrative                 32,657 31,517 26,041
Acquisition related costs                 3,378 9,394 12,239
Impairment of assets                 1,304    
Total expenses                 41,131 44,703 42,072
Operating income                 (23,554) (26,947) (24,367)
Interest and other income                 711 1,117 1,451
Interest expense                 (73,635) (66,686) (53,404)
Loss on early extinguishment of debt                 (797) (6,349) (427)
Income from continuing operations before income tax expense and equity in earnings of an investee                 (97,275) (98,865) (76,747)
Income tax expense                 (600) (375) (312)
Equity in earnings of an investee                 334 316 139
Income from continuing operations                 (97,541) (98,924) (76,920)
Discontinued Operations:                      
Income before gain (loss) on sale of properties                 (97,541) (98,924) (76,920)
Net income                 (97,541) (98,924) (76,920)
Total assets $ 279,426       $ 296,341       $ 279,426 $ 296,341 $ 434,152