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Segment Reporting (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 6 Months Ended
Jun. 30, 2014
Jun. 30, 2013
Jun. 30, 2014
item
Jun. 30, 2013
Dec. 31, 2013
Segment Reporting          
Number of operating segments     4    
Number of reportable segments     3    
Revenues:          
Rental income $ 127,669 $ 112,297 $ 239,724 $ 224,150  
Residents fees and services 79,039 74,631 158,481 149,687  
Total revenues 206,708 186,928 398,205 373,837  
Expenses:          
Property operating expenses 79,786 74,484 157,590 148,163  
Depreciation 46,703 38,296 85,058 75,999  
General and administrative 9,577 8,168 17,866 16,816  
Acquisition related costs 2,512 292 2,635 2,187  
Impairment of assets   4,371   5,675  
Total expenses 138,578 125,611 263,149 248,840  
Operating income 68,130 61,317 135,056 124,997  
Interest and other income 154 397 258 570  
Interest expense (34,112) (29,567) (63,012) (59,131)  
Loss on early extinguishment of debt   (105)   (105)  
Income from continuing operations before income tax expense and equity in earnings of an investee 34,172 32,042 72,302 66,331  
Income tax expense (155) (140) (346) (280)  
Equity in earnings of an investee 118 79 21 155  
Income from continuing operations 34,135 31,981 71,977 66,206  
Discontinued Operations:          
Income from discontinued operations 741 1,513 2,041 2,523  
Impairment of assets from discontinued operations 387 (27,896) (334) (27,896)  
Income before gain on sale of properties 35,263 5,598 73,684 40,833  
Gain on sale of properties 2,396   2,552    
Net income 37,659 5,598 76,236 40,833  
Total assets 6,016,855 4,748,631 6,016,855 4,748,631 4,764,666
Triple Net Leased Net Senior Living Communities
          
Revenues:          
Rental income 55,166 56,957 110,055 113,723  
Total revenues 55,166 56,957 110,055 113,723  
Expenses:          
Depreciation 15,515 17,019 31,152 33,936  
Impairment of assets   4,371   4,371  
Total expenses 15,515 21,390 31,152 38,307  
Operating income 39,651 35,567 78,903 75,416  
Interest expense (6,472) (6,596) (12,860) (13,060)  
Income from continuing operations before income tax expense and equity in earnings of an investee 33,179 28,971 66,043 62,356  
Income from continuing operations 33,179 28,971 66,043 62,356  
Discontinued Operations:          
Income before gain on sale of properties 33,179   66,043    
Gain on sale of properties 2,396   2,552    
Net income 35,575 28,971 68,595 62,356  
Total assets 1,806,867 1,829,372 1,806,867 1,829,372  
Managed Senior Living Communities
          
Revenues:          
Residents fees and services 79,039 74,631 158,481 149,687  
Total revenues 79,039 74,631 158,481 149,687  
Expenses:          
Property operating expenses 60,624 58,231 121,412 116,135  
Depreciation 8,333 7,028 16,488 13,877  
Total expenses 68,957 65,259 137,900 130,012  
Operating income 10,082 9,372 20,581 19,675  
Interest expense (2,806) (3,073) (5,794) (6,141)  
Income from continuing operations before income tax expense and equity in earnings of an investee 7,276 6,299 14,787 13,534  
Income from continuing operations 7,276 6,299 14,787 13,534  
Discontinued Operations:          
Income before gain on sale of properties 7,276   14,787    
Net income 7,276 6,299 14,787 13,534  
Total assets 922,557 964,610 922,557 964,610  
MOBs
          
Revenues:          
Rental income 68,027 50,899 120,791 101,582  
Total revenues 68,027 50,899 120,791 101,582  
Expenses:          
Property operating expenses 19,162 16,253 36,178 32,028  
Depreciation 21,907 13,301 35,522 26,290  
Total expenses 41,069 29,554 71,700 58,318  
Operating income 26,958 21,345 49,091 43,264  
Interest expense (1,507) (1,387) (2,844) (2,734)  
Income from continuing operations before income tax expense and equity in earnings of an investee 25,451 19,958 46,247 40,530  
Income from continuing operations 25,451 19,958 46,247 40,530  
Discontinued Operations:          
Income from discontinued operations 741 1,513 2,041 2,523  
Impairment of assets from discontinued operations 387 (27,896) (334) (27,896)  
Income before gain on sale of properties 26,579   47,954    
Net income 26,579 (6,425) 47,954 15,157  
Total assets 2,967,167 1,742,120 2,967,167 1,742,120  
All Other Operations
          
Revenues:          
Rental income 4,476 4,441 8,878 8,845  
Total revenues 4,476 4,441 8,878 8,845  
Expenses:          
Depreciation 948 948 1,896 1,896  
General and administrative 9,577 8,168 17,866 16,816  
Acquisition related costs 2,512 292 2,635 2,187  
Impairment of assets       1,304  
Total expenses 13,037 9,408 22,397 22,203  
Operating income (8,561) (4,967) (13,519) (13,358)  
Interest and other income 154 397 258 570  
Interest expense (23,327) (18,511) (41,514) (37,196)  
Loss on early extinguishment of debt   (105)   (105)  
Income from continuing operations before income tax expense and equity in earnings of an investee (31,734) (23,186) (54,775) (50,089)  
Income tax expense (155) (140) (346) (280)  
Equity in earnings of an investee 118 79 21 155  
Income from continuing operations (31,771) (23,247) (55,100) (50,214)  
Discontinued Operations:          
Income before gain on sale of properties (31,771)   (55,100)    
Net income (31,771) (23,247) (55,100) (50,214)  
Total assets $ 320,264 $ 212,529 $ 320,264 $ 212,529