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Segment Reporting (Details)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2015
USD ($)
Mar. 31, 2015
USD ($)
Sep. 30, 2014
USD ($)
Sep. 30, 2015
USD ($)
segment
Sep. 30, 2014
USD ($)
Dec. 31, 2014
USD ($)
Segment reporting            
Number of operating segments | segment       4    
Number of reportable segments | segment       3    
Revenues:            
Rental income $ 158,863   $ 137,614 $ 460,193 $ 377,339  
Residents fees and services 96,412   79,259 271,061 237,740  
Total revenues 255,275   216,873 731,254 615,079  
Expenses:            
Property operating expenses 96,927   82,706 276,313 240,297  
Depreciation 70,016   50,074 186,234 135,132  
General and administrative 10,316   10,384 32,563 28,250  
Acquisition related costs 742   15 6,517 2,649  
Impairment of assets (98)     (98)    
Total expenses 177,903   143,179 501,529 406,328  
Operating income 77,372   73,694 229,725 208,751  
Interest and other income 57   78 274 336  
Interest expense (38,989)   (36,201) (112,838) (99,213)  
Loss on early extinguishment of debt (21) $ (1,409)   (1,469)    
Income (loss) before income tax expense and equity in earnings of an investee 38,419   37,571 115,692 109,874  
Income tax expense (146)   (156) (385) (502)  
Equity in (losses) earnings of an investee (24)   38 70 59  
Income from continuing operations 38,249   37,453 115,377 109,431  
Discontinued Operations:            
(Loss) income from discontinued operations     (557) (350) 1,484  
Impairment of assets from discontinued operations     216 (602) (117)  
Income before gain on sale of properties 38,249   37,112 114,425 110,798  
Gain on sale of properties         2,552  
Net income 38,249   37,112 114,425 113,350  
Total assets 7,352,996   5,989,122 7,352,996 5,989,122 $ 5,968,269
Triple Net Leased Net Senior Living Communities            
Revenues:            
Rental income 64,222   55,266 180,820 165,321  
Total revenues 64,222   55,266 180,820 165,321  
Expenses:            
Depreciation 19,140   15,372 51,322 46,525  
Impairment of assets (98)     (98)    
Total expenses 19,042   15,372 51,224 46,525  
Operating income 45,180   39,894 129,596 118,796  
Interest expense (6,342)   (6,446) (18,598) (19,307)  
Loss on early extinguishment of debt       (6)    
Income (loss) before income tax expense and equity in earnings of an investee 38,838   33,448 110,992 99,489  
Income from continuing operations 38,838   33,448 110,992 99,489  
Discontinued Operations:            
Income before gain on sale of properties     33,448   99,489  
Gain on sale of properties         2,552  
Net income 38,838   33,448 110,992 102,041  
Total assets 2,264,217   1,823,234 2,264,217 1,823,234  
Managed Senior Living Communities            
Revenues:            
Residents fees and services 96,412   79,259 271,061 237,740  
Total revenues 96,412   79,259 271,061 237,740  
Expenses:            
Property operating expenses 71,983   61,330 204,178 182,742  
Depreciation 19,248   8,006 41,357 24,494  
Total expenses 91,231   69,336 245,535 207,236  
Operating income 5,181   9,923 25,526 30,504  
Interest expense (2,705)   (2,416) (7,285) (8,210)  
Loss on early extinguishment of debt       (33)    
Income (loss) before income tax expense and equity in earnings of an investee 2,476   7,507 18,208 22,294  
Income from continuing operations 2,476   7,507 18,208 22,294  
Discontinued Operations:            
Income before gain on sale of properties     7,507   22,294  
Net income 2,476   7,507 18,208 22,294  
Total assets 1,291,623   899,545 1,291,623 899,545  
MOBs            
Revenues:            
Rental income 90,072   77,798 265,664 198,589  
Total revenues 90,072   77,798 265,664 198,589  
Expenses:            
Property operating expenses 24,944   21,376 72,135 57,555  
Depreciation 30,680   25,748 90,711 61,269  
Total expenses 55,624   47,124 162,846 118,824  
Operating income 34,448   30,674 102,818 79,765  
Interest expense (1,707)   (1,484) (5,232) (4,328)  
Income (loss) before income tax expense and equity in earnings of an investee 32,741   29,190 97,586 75,437  
Income from continuing operations 32,741   29,190 97,586 75,437  
Discontinued Operations:            
(Loss) income from discontinued operations     (557) (350) 1,484  
Impairment of assets from discontinued operations     216 (602) (117)  
Income before gain on sale of properties     28,849   76,804  
Net income 32,741   28,849 96,634 76,804  
Total assets 3,393,253   2,953,668 3,393,253 2,953,668  
All Other Operations            
Revenues:            
Rental income 4,569   4,550 13,709 13,429  
Total revenues 4,569   4,550 13,709 13,429  
Expenses:            
Depreciation 948   948 2,844 2,844  
General and administrative 10,316   10,384 32,563 28,250  
Acquisition related costs 742   15 6,517 2,649  
Total expenses 12,006   11,347 41,924 33,743  
Operating income (7,437)   (6,797) (28,215) (20,314)  
Interest and other income 57   78 274 336  
Interest expense (28,235)   (25,855) (81,723) (67,368)  
Loss on early extinguishment of debt (21)     (1,430)    
Income (loss) before income tax expense and equity in earnings of an investee (35,636)   (32,574) (111,094) (87,346)  
Income tax expense (146)   (156) (385) (502)  
Equity in (losses) earnings of an investee (24)   38 70 59  
Income from continuing operations (35,806)   (32,692) (111,409) (87,789)  
Discontinued Operations:            
Income before gain on sale of properties     (32,692)   (87,789)  
Net income (35,806)   (32,692) (111,409) (87,789)  
Total assets $ 403,903   $ 312,675 $ 403,903 $ 312,675