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Segment Reporting (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 9 Months Ended
Sep. 30, 2014
Sep. 30, 2013
Sep. 30, 2014
item
Sep. 30, 2013
Dec. 31, 2013
Segment reporting          
Number of operating segments     4    
Number of reportable segments     3    
Revenues:          
Rental income $ 137,614 $ 112,319 $ 377,339 $ 336,468  
Residents fees and services 79,259 74,946 237,740 224,634  
Total revenues 216,873 187,265 615,079 561,102  
Expenses:          
Property operating expenses 82,706 74,729 240,297 222,893  
Depreciation 50,074 38,473 135,132 114,472  
General and administrative 10,384 7,798 28,250 24,615  
Acquisition related costs 15 396 2,649 2,590  
Impairment of assets       5,675  
Total expenses 143,179 121,396 406,328 370,245  
Operating income 73,694 65,869 208,751 190,857  
Interest and other income 78 42 336 612  
Interest expense (36,201) (29,405) (99,213) (88,536)  
Loss on early extinguishment of debt   (692)   (797)  
Income from continuing operations before income tax expense and equity in earnings of an investee 37,571 35,814 109,874 102,136  
Income tax expense (156) (125) (502) (405)  
Equity in earnings of an investee 38 64 59 219  
Income from continuing operations 37,453 35,753 109,431 101,950  
Discontinued Operations:          
Income from discontinued operations (557) 1,231 1,484 3,762  
Impairment of assets from discontinued operations 216   (117) (27,896)  
Income before gain on sale of properties 37,112 36,984 110,798 77,816  
Gain on sale of properties   1,141 2,552 1,141  
Net income 37,112 38,125 113,350 78,957  
Total assets 5,989,122 4,807,330 5,989,122 4,807,330 4,764,666
Triple Net Leased Net Senior Living Communities
          
Revenues:          
Rental income 55,266 57,073 165,321 170,794  
Total revenues 55,266 57,073 165,321 170,794  
Expenses:          
Depreciation 15,372 16,760 46,525 50,696  
Impairment of assets       4,371  
Total expenses 15,372 16,760 46,525 55,067  
Operating income 39,894 40,313 118,796 115,727  
Interest expense (6,446) (6,546) (19,307) (20,030)  
Income from continuing operations before income tax expense and equity in earnings of an investee 33,448 33,767 99,489 95,697  
Income from continuing operations 33,448 33,767 99,489 95,697  
Discontinued Operations:          
Income before gain on sale of properties   33,767 99,489 95,697  
Gain on sale of properties   1,141 2,552 1,141  
Net income 33,448 34,908 102,041 96,838  
Total assets 1,823,234 1,861,729 1,823,234 1,861,729  
Managed Senior Living Communities
          
Revenues:          
Residents fees and services 79,259 74,946 237,740 224,634  
Total revenues 79,259 74,946 237,740 224,634  
Expenses:          
Property operating expenses 61,330 57,708 182,742 173,844  
Depreciation 8,006 7,251 24,494 21,128  
Total expenses 69,336 64,959 207,236 194,972  
Operating income 9,923 9,987 30,504 29,662  
Interest expense (2,416) (3,054) (8,210) (9,196)  
Income from continuing operations before income tax expense and equity in earnings of an investee 7,507 6,933 22,294 20,466  
Income from continuing operations 7,507 6,933 22,294 20,466  
Discontinued Operations:          
Income before gain on sale of properties   6,933 22,294 20,466  
Net income 7,507 6,933 22,294 20,466  
Total assets 899,545 967,187 899,545 967,187  
MOBs
          
Revenues:          
Rental income 77,798 50,910 198,589 152,492  
Total revenues 77,798 50,910 198,589 152,492  
Expenses:          
Property operating expenses 21,376 17,021 57,555 49,049  
Depreciation 25,748 13,514 61,269 39,804  
Total expenses 47,124 30,535 118,824 88,853  
Operating income 30,674 20,375 79,765 63,639  
Interest expense (1,484) (1,369) (4,328) (4,103)  
Income from continuing operations before income tax expense and equity in earnings of an investee 29,190 19,006 75,437 59,536  
Income from continuing operations 29,190 19,006 75,437 59,536  
Discontinued Operations:          
Income from discontinued operations (557) 1,231 1,484 3,762  
Impairment of assets from discontinued operations 216   (117) (27,896)  
Income before gain on sale of properties   20,237 76,804 35,402  
Net income 28,849 20,237 76,804 35,402  
Total assets 2,953,668 1,732,217 2,953,668 1,732,217  
All Other Operations
          
Revenues:          
Rental income 4,550 4,336 13,429 13,182  
Total revenues 4,550 4,336 13,429 13,182  
Expenses:          
Depreciation 948 948 2,844 2,844  
General and administrative 10,384 7,798 28,250 24,615  
Acquisition related costs 15 396 2,649 2,590  
Impairment of assets       1,304  
Total expenses 11,347 9,142 33,743 31,353  
Operating income (6,797) (4,806) (20,314) (18,171)  
Interest and other income 78 42 336 612  
Interest expense (25,855) (18,436) (67,368) (55,207)  
Loss on early extinguishment of debt   (692)   (797)  
Income from continuing operations before income tax expense and equity in earnings of an investee (32,574) (23,892) (87,346) (73,563)  
Income tax expense (156) (125) (502) (405)  
Equity in earnings of an investee 38 64 59 219  
Income from continuing operations (32,692) (23,953) (87,789) (73,749)  
Discontinued Operations:          
Income before gain on sale of properties   (23,953) (87,789) (73,749)  
Net income (32,692) (23,953) (87,789) (73,749)  
Total assets $ 312,675 $ 246,197 $ 312,675 $ 246,197